Crispin Speers & Partners - Request to cover activity under travel insurance  

You should refer here only activities that are specifically excluded by the insurance. All other activities are covered as standard and do NOT need to be referred.  
Please fill in all fields marked with a *
Please confirm that the activity declared is excluded by the insurance.
Employee number *
Company *
Contract Number if known
Your Name *
Your postcode *
Your E Mail address *
Destination *
Start date for your trip
End date for your trip
Activities you wish to undertake *
Website with additional information
Additional Information you wish to provide

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