Pit and Paddock Bike Sport Insurance Specialists
  
 
  
Get Quote

Existing User?
If you have used our site before please enter your email address and password below to retrieve your details:

Email Address:
Password:
Lost your password? click here to get your password emailed to you.

Your Details - New User
Title:
Forename: Surname:
Address Line 1:
Address Line 2:
Town:
County:
Postcode:
How did you find us:
Date of Birth [dd/mm/yy]:
Occupation:
Telephone:
Fax: Mobile:
Email:

Note: Check email address. If incorrect our formal quotation will not reach you since this is only sent by email		 Password:

Bike Details
Make & Model:  
Year of Manufacture:  
Current Market Value:  


Details of Cover
Type of Cover:    Definitions
Excess:     each and every loss
Bodywork and Fairings Covered?    Definitions
No of Trackdays:  

Required Details
Bike Registration:  
How long have you owned the bike?  
If you are not the legal owner please state who legally owns the bike:  
Details of any previous trackday accidents. If 'None', click the box below  
      None
Name of Road Insurer:  

Track Dates
  Date Circuit Organiser
Please select the qty of trackdays you require.

Note: We will need to know all dates, circuits and organisers PRIOR to taking to the track. If you are unsure of all dates at the time of paying for your policy, you should submit on-line future details when they are known by clicking on 'MY DATES'.

Declaration
Material Facts and Non Disclosure
I/we hereby declare that to the best of my/our knowledge, that the statements made in this proposal are true and complete and that I/we have not suppressed or mis-stated any material facts. (Further Details)

Policy Wording
It is important that you read the policy wording before you effect cover with ourselves. (Policy Wording)

Application
I/we agree that this application and declaration, together with any information supplied by me/us, shall form the basis of the contract between myself/ourselves and the Insurer.
I/we understand that completion of this application form does not bind myself/ourselves or the Insurer to any form of insurance contract.

Privacy and Security

Important: I/we confirm that I/we have read and understood the above. Further I/we confirm we have checked the accuracy of all information supplied above.


    Premium inc. Insurance Premium Tax £


    Profile : Terms of Business : Contact : Links : Register : Privacy & Security : Legal
   © 1998-2008 Everitt Boles Ltd  :  Authorised and regulated by the Financial Services Authority  :  Site design by AGC Design