Regulatory Trials Quotation

Name

Date of Birth--

Address

Telephone Number

Email Address

I confirm no rider to be insured on this policy has more than 6 points on licence, no driving ban in the last 5 years no claims on motor or home policies in the last 3 years

If the answer is no please provide details

Are you a member of any owners clubs?

Bike 1 Make

Bike 1 Model

Bike 1 Engine Size (cc)

Bike 1 Year

Bike 1 Value

How long have you owned this bike?

Bike 2 Make

Bike 2 Model

Bike 2 Engine Size (cc)

Bike 2 Year

Bike 2 Value

How long have you owned this bike?

Bike 3 Make

Bike 3 Model

Bike 3 Engine Size (cc)

Bike 3 Year

Bike 3 Value

How long have you owned this bike?

Bike 4 Make

Bike 4 Model

Bike 4 Engine Size (cc)

Bike 4 Year

Bike 4 Value

How long have you owned this bike?

Regulatory Trials Insurance