Topper Worlds Sailing Insurance
Information and expression of interest request
Email address *
Personal Information
Lead Adult
Full Name (as per passport) *
Your answer
Date of Birth *
Your answer
Additional travelling party members
Full Name (as per passport)
Your answer
Date of Birth
Your answer
Full Name (as per passport)
Your answer
Date of Birth
Your answer
Full Name (as per passport)
Your answer
Date of Birth
Your answer
Full Name (as per passport)
Your answer
Date of Birth
Your answer
Full Name (as per passport)
Your answer
Date of Birth
Your answer
Contact Details
Address *
Your answer
Do all named people reside at above address?
Daytime contact telephone number *
Your answer
Questions to assist with your insurance quote
Please name anyone who does not require an insurance quote *
Your answer
Departure Date from the UK *
Your answer
Date of return to the UK *
Your answer
Countries visited during trip *
Your answer
Do you have any pre-existing medical conditions that you require to have covered by this policy? *
If yes above, who requires their existing medical condition to be covered?
Your answer
Is sailing race cover required? *
If sailing cover required, who is it required for? *
Your answer
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