Your Details
Full Name
Complete Address
Date of birth
Referred By / Promo Offer
Boat detail
Type or Class
Year Built
Is vessel a conversion
Date boat purchased
Price paid (including currency)
Engine and Cruising area
Are outboards permanently locked to transom or stored in locked premises when not in use?  
Cruising Area
Are the following areas fitted with an automatic or remote fire extinguishing system?  
Tank Space
Is liquefied petroleum gas (LPG) used?  
Where is the vessel moored?
Type of mooring?
Is the vessel laid up ashore or afloat?  
Cover required
What cover do you require? (Fully comprehensive/Third party)
Do you intend to sail single handed?  
Cover required for private and pleasure only?  
Cover required for Living on Board?  
Cover required for hire/charter/commercial?  
Cover for Wreck Removal and Salvage?  
Cover required for racing?  
Cover required for water skiing?  
Cover required for Windstorm?  
Cover required for Night Navigation?  
Do you required public liability cover?  
Cover start date?
Sums Insured
Input currency
Hull/Machinery/Gear/Equipment only
Outboard Motor
Personal Effects (Maximum £100 (or equivalent currency) any item unless specified)
Navigation Equipment (Maximum £100 (or equivalent currency) any item unless specified)
Mast/Spars/Sails/Standing and Running Rigging (If racing risk required)

Total (excluding Third Party Liability level)

Severe storm
It is understood and agreed that in the event of a SS warning, I/We will make every reasonable effort to safeguard the vessel and/or its equipment, including but not limited to removing/stowing of sails, bimini cover, loose items, outriggers and antennas.
Have you ever had insurance on any vessel declined or Special Terms imposed?  
Have you ever had any accidents or losses in respect of any vessel?  
Have you ever been charged with or convicted of any offence involving dishonesty?  
Are you the sole owner of the vessel?  
Is the vessel the subject of any mortgage or financial agreement?  
 I hereby declare that all the information I have given on the proposal form is correct at the time of signing and that I understand I would be obliged to inform insurers of any changes that occur during the policy period and that failure to do so could invalidate this contract insurance. I also declare that if anything on this form was written by another person he/she acted as my agent for this purpose. 
Clicking below does not bind the proposer to complete this insurance. The Company reserves the right to decline any proposal. The Proposer should keep a record of all information supplied to the Insurer for the purpose of entering into the Contract, and a copy of this Proposal will be supplied on request, within a period of three months after completion.This insurance Contract will be placed with an Insurer located outside the European Community and therefore as a non-authorised or permitted Insurer you will not be protected by any Policy Holder Protection Acts or Data Protection Acts within the European community that may apply.
 Please confirm you have read and accept the policy clauses.
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