Travel Insurance

Will you be participating in any hazardous activities, including sports such as diving, skiing, mountaineering, motorcycling?YesNo
Will you be visiting Canada/USA?

1. I declare that to the best of my knowledge and belief, All persons proposed for this insurance at the time of effecting this insurance
- are free from any illness or infirmity and are not undergoing any treatment which could result in medical expenses being incurred.
- have not made any claim under this type of insurance or similar during the past 3 years.
2. I agree that this proposal is for insurance in the normal terms and conditions of the
Insurers policy and shall form part of the insurance contract.