English Karate Federation Instructor Insurance Proposal Form

Step 1 of 3: Submit

Please complete this form including all mandatory fields. Proposal form will be submitted upon successful payment where your proposal will be processed. Please contact Registration for queries.


Fun4Sure & LRO Insurance

It is essential you provide us with ALL MATERIAL FACTS. Failure to disclose all material facts may invalidate your insurance or may result in the insurance not operating fully.



Do you sell goods to the public: *

If 'Yes' please note cover is limited to:
Products limited to Food & Drink and/or Associated Sports Equipment and/or Accessories sold or supplied



Claims History

Please provide details of any previous claims made.



Declaration

To the best of my knowledge and belief the information provided in connection with this declaration, whether in my own hand or not, is true and I have not withheld any material facts. I understand that non-disclosure or misinterpretation of a material fact may entitle insurers to void the insurance. (N.B. a Material fact is one likely to influence acceptance or assessment of the risk by Insurers. If you are in doubt as to whether a fact is material or not, please discloses it).
I understand that signing this declaration does not bind me to complete, or Insurers to accept, this insurance.


Date: Tuesday, 13 November 2018 (EST)
Name:
Type your name to sign this document:
Typing name is equivalent to a handwritten signature

Fun4Sure & LRO Insurance are trading names of Frita Insurance Services Ltd. 150 Minories London EC3N 1LS
Tel: 0207 347 5160; Fax: 0207 347 5161; email info@lroinsurance.co.uk; Website: www.lroinsurance.co.uk;
Authorised & Regulated by the Financial Services Ltd. (FSA Register No. 311136) Registered in England & Wales No. 02761363

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