Boat Insurance Questionaire

First name*

Last name*

Email*

Legion Member 25-26*

Yes

No

Which Island are you based on ?*

North Island

South Island

North Island*

Do you allow the boat to be used for racing events ?*

Yes

No

Type of Boat*

Single

Double / Pair

Quad / Four

Octi / Eight

Single choice*

Skiff

Coastal

Other

Make of Boat*

Kirs / Laszlo

SLR

Wintech

Kangua

Swift

King

Filipi

Other

Year of Manufacture*

Weight, Deecription or Model Number*

Value for Insurance Purposes*

Stored where ?*

Club

Home

Bach

Other

Other items to be insured for regattas ?

Oars/Aculls

Stroke Coach

Boat Bag

Other

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I hereby confirm that I have read the Legion's Group Policy Insurance Administration Disclosure and accept the terms thereof

The Legion of Rowers Incorporated

Registered Number: 334000

NZBN: 9429042779803

IRD Number: 132-183-767

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