Insurance and finance, covering the Costa del Sol and beyond

Golf Insurance Form

Premium is based on the level of capital value of your golf equipment. Select level of cover required:

Equipment Value / Premium

Personal Details:

Name:

E-mail:

Phone:

NIE or passport:

Spanish Address:

Address (if different):

Date of Birth:

Profession:

Level of cover required:

Equipment (select premium value from 1st option):

Third party liability (€100,000)

Hole In One (€210)

Personal Accident Cover (suffered at golf club):

Death (€15,000)

Permanent Invalidity (€15,000)

Medical / Pharmaceutical Assistance(€3,000)

Caddie Medical / Pharmaceutical Assistance(€3,000)

General Information:

Where are your clubs and accessories kept when not in use?

Details, if applicable, of claims made on a similar policy during the last 3 years:

Details, if applicable, of any physical impairment which might affect the personal accident cover:

Name of golf club where you are a member:

Name of beneficiary in case of death:

Payment information:

Please debit my account with (premium amount):

Euros

Spanish Bank Account Details:

Credit Card details in event of no Spanish bank available:

Credit Card number and expiry date:

* Note cover is not in force until payment has been received and the risk accepted by the underwriters *














Rightway Insurance & Finance SL, CC Las Postas, Local 9,
Sitio de Calahonda, 29649 Mijas Costa, Málaga. Tel: (+34) 952 934 963 Fax: (+34) 952 939 097
Email: info@rightwaysl.com