APPLICATION FOR BSCA EVENT INSURANCE

Please complete the details below and send with the relevant fee to the General Secretary at least 1 month before your event.

 

To: The General Secretary (Susan Knight)

21 Bedhampton Road, North End, Portsmouth PO2 7JX

 

PLEASE ARRANGE INSURANCE COVER (@ £10 per day) for;

 

Type of event ……………………………………………………………

To be held at (venue)…………………………………………………….

Date(s)………………………………………….

Commencing at  ……………………………………..

Headquarters…………………………………………………………………..

Open to the following age groups (Delete as appropriate):-

Under 8, Under 10, Under 12, Under 14, Under 16, Over 16

Promoting club/organisation  …………………………………………….

Membership No  ……………………………

Event Organiser  ………………………………………………..

Address  …………………………………………………………

……………………………………………………………………

…………………………………………………………………….

Post code   ……………………………..

Tel:…………………………………………………. Mobile………………………………………………..

Email: …………………………………………………………………

Signed………………………………………..