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Name
Email Address
Daytime Telephone Number
Postcode
Date of Birth
What year was the vessel built?
What is the length of the vessel (in feet)
What is the cruising range of the vessel?
Please select...
Cruising inland UK
Cruising Inland & coastal UK
Inland and coastal waters of the UK extended to include continental Waters for Brest to the River Elb
Mediterranean waters not East of 15 degrees East and not South of 34 degrees North
Mediterranean waters not East of 35 Degrees East and not South of 34 degrees North
Other
How many years boating experience do you have skippering the type of craft?
What type of vessel is it?
Please select...
Canal/Narrow Boat
Motor Boat
Speed Boat
Cruiser
Yacht
Pleasure craft
Name of Craft
where is the craft registered?
Please select...
UK
Not registered
Other
Make / Model of craft?
What year did you purchase your vessel?
What was the purchase price of the vessel?
Date of most recent survey? (if you have one)
Engine Make?
Year of Engine make
Power of Vessel (HP)?
Engine Type?
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Inboard
Outboard
Engine Fuel
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Petrol
Diesel
Is the engine a single or twin
Please select...
Single
Twin
Vessel use
Mooring Location
Hull Material
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GRP
Steel
Wood
Aluminium
Sum Insured Hull & Machinery
Sum Insured Tender
Sum Insured Outboard Motor
Sum Insured Personal Effects
Sum Insured Trailer
Sum Insured Other
Do you have any no claims discunt
Please select...
No
1 Year
2 Years
3 Years
4 Years
5 + Years
Have you had any claims in the past 5 years
Have you had any convicitions in the past 5 years?
Please select...
Yes
No
Is your vessel used for racing
Please select...
Yes
No
Is the vessel used for private pleasure purposes only
Please select...
Yes
No
Is your vessel professionally built of GRO, aluminium, steel or wood?
Please select...
Yes
No
You and your vessel are based in the UK
Please select...
Yes
No
If you have answered yes to any of the above please give details here