Club registration forms
28/3/2010 - 27/3/2011
2010 FORM FOR IBF/BCSA CLUB MEMBERSHIP & PL INSURANCE
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 28/3/2011
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 £50
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
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