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Pleasure craft
Please take a moment to fill out this form and one of our brokers will contact you shortly to offer you a quotation or discuss your requirements further.
Title
*
[Please select]
Mr
Mrs
Miss
Ms
First name
*
Second/middle name
Surname
*
Date of birth
*
Place of birth
*
Sex
*
[Please select]
Male
Female
What is your occupation
*
Are you self employed
*
[Please select]
Yes
No
What is your employers business
Name or number of your home
*
Postcode
*
Do you own or rent this property
*
[Please select]
I own it
I rent it
E-mail address
*
Daytime contact number (including code)
*
Evening contact number (including code)
Mobile contact number (including code)
How did you hear about us
*
[Please select]
Existing client
Past client
Recommendation
Radio advert
Press advert
Yellow pages
Facebook
When do you need this insurance to start
*
What is the name of the vessel
*
Builders name
*
What type of vessel is it
*
When was it built (year)
*
What is its length
*
What is its beam
*
What is its draft
*
What is its construction
*
[Please select]
GRP
Wood
Other
What is make of engine
*
What is the maximum design speed (knots)
*
What is engine HP
*
What is engine age (year)
*
What fuel?
*
[Please select]
Petrol
Diesel
Is it inboard or outboard
*
[Please select]
Inboard
Outboard
How many years sailing do you have
*
[Please select]
First time
1-2 years
3-4 years
5-6 years
More than 6 years
What will be boat be used for
*
[Please select]
Pleasure
Commercial
Describe type of commercial use
Is gas used onboard?
*
[Please select]
Yes
No
Third party liability
*
[Please select]
£3m
other
Waterskiing liability
*
[Please select]
£2m
No waterskiing
Inflatable toys liability
*
[Please select]
Yes
No
Racing risks extension – enter value of masts, spars and sails £
Where is it moored
*
Type of mooring
*
[Please select]
Marina
Swinging
Fore and aft
What cruising range do you require
*
[Please select]
Channel Island waters
Channel Islands and adjacent French coast
Brest to Elbe
Other
What is the total sum insured required £
*
Have you made any previous claims
*
[Please select]
Yes
No
No claims discount
*
[Please select]
Nil
1 year
2 years
3 years
4 years
5 years or more
Privacy and Data Protection
The Rossborough Group holds your details in accordance with relevant Data Protection Law in the UK, Isle of Man and Channel Islands. Some or all of the information you supply to us in connection with your insurance proposal will be held on computer and may be passed to insurance companies for underwriting and claims purposes. In addition, we may use some of the information to advise you of other products and services offered by the Rossborough Group. If you do not wish to receive such details please contact our Compliance Officer.
Please take a moment to fill out this form and one of our brokers will contact you shortly to offer you a quotation or discuss your requirements further.
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