EmailMe Form - Short Mat Bowls Enquiry Form

Name of club

Address of home venue

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region

Number of members

Maximum authorised number of members

Contact Name

Contact Address

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region

Telephone Number

Email address

Property cover –
sum insured required:

Public Liability – indemnity limit required:

£1,000,000

£2,000,000

£5,000,000

Is it intended to organise any Social Events during the period of the proposed insurance?

Yes

No

Have any claims been made against the Club or its Members during the last 5 years?

Yes

No

Has any insurer previously declined to accept a proposal from the Club?

Yes

No

If you have answered “yes” to any of the above questions, please provide details below including details of any social events to be arranged over the coming year.

Previous Insurers

Present Insurers

Approximate Premium

Renewal Date

DD / MM / YYYY

Where did you hear about Norris and Fisher?

Preferred method of contact

Please declare if any Principals/Committee Members/Trustees have had any of the following: *

Previous insurance declined, cancelled or terms applied

Declared bankrupt or had any unsatisfied County Court Judgments

Convicted with or charged with or received caution for any criminal offence other than motoring that is not spent

None of the above

If you answer yes to any of the first three options, please provide further information below

Additional Information

*

I have read and agree to the terms and conditions.

PLEASE INDICATE YOUR ACCEPTANCE BY CLICKING 'I HAVE READ AND AGREE TO THE TERMS & CONDITIONS'

Our terms and conditions can be read on our website at www.norrisandfisher.com/terms

Norris and Fisher (Insurance Brokers) Ltd complies with the requirements of the Data Protection Act (DPA) 1998 and General Data Protection Regulations (GDPR) 2018. This Act places legal obligations upon Norris and Fisher (Insurance Brokers) Ltd in respect of the way we collect, review, distribute and store personal data.

In order to assess your application and help us reach a decision, we need to process relevant personal details. By signing this form, you are giving your consent for Norris and Fisher (Insurance Brokers) Ltd to do this.