|
IBF JUDO INSTRUCTOR COURSE 2012 |
Club registration forms 28/3/2012 - 27/3/2013
2011 FORM FOR IBF/BCSA CLUB MEMBERSHIP & PL INSURANCE £60 Member Club 28/3/12 till 27/3/13 All questions to be completed fully in block capitals. All officials must be registered with the Criminal Records Bureau (forms available from HQ) Please complete in BLOCK CAPITALS (eligible form will be returned) Renewal Date 28/3/2013 LIMIT OF INDEMNITY £5,000,000 Please Note : Insurance will not commence until a correctly completed and signed proposal form and your cheque is received by our insurance broker Worldwide Sports Insurance Uk Ltd . All cover is subject to the terms, conditions and exceptions of the master policy held by our broker and is available for inspection upon request. Please read the following declaration, sign at the bottom and return this form, together with your cheque. Fee £60 Declaration: I declare that to the best of my knowledge and belief there are no known incidents or circumstances that might give rise to a claim
Signed ... ... ... ... ... ... ... ... ... ... ... ... ... ... .. Date ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... . You can pay over the internet via Internet Banking or Paypal or Cheque sent to HQ
|