Sailing Form - Tour Passenger

Complete this form if you are a passenger or crew member and would like to receive a quote for our sailing cover

1. Applicant Name*
2. Applicant Age*
3. Email*
4. Phone
5. Date of departure from Australia*
Date Format: DD slash MM slash YYYY
6. Date of return to Australia*
Date Format: DD slash MM slash YYYY
7. Where will you be sailing
ie Fiji, Singapore, Canada etc
8. Will you be participating in a race, rally or regatta?*
- Yes - Go to question 9
- No - Leisure Only - Go to question 12
9. Please provide details of the race, rally or regatta including whether you will be sailing / racing at night
ie Hawaiian World Cup. No night sailing.
10. Start date of event
Date Format: DD slash MM slash YYYY
11. End date of event
Date Format: DD slash MM slash YYYY
12. Please detail your sailing / boating experience and qualifications.*
13. Will you be a crew member or passenger?*
14. What activities do you intend to perform onboard?*
15. Have you had any accidents, claims or losses in connection with any vessel you have been on in the last 5 years?*
- Yes
- No
If yes, please advise.
16. Have you ever been refused insurance?*
- Yes
- No

Sailing Form – Tour Passenger