Back to STB Insurance EKF Page Full Name of Association or Club*Full Name of Licencing officer*Email* Phone*Number of Members to be Insured*Premium is £2.20 per memberProduct NameEnter First Name, Surname and Date of Birth of each member to be Insured*Your premium is: £ 0.00 Premiums include insurance premium tax at 12% and a policy fee.Date cover is required* Date Format: DD slash MM slash YYYY Activities are Karate only?*(cover excludes the use of live/sharp blades)YesNoPlease phone us on 01603 626904 as this will need to be agreed in advanceAny previous claims?*YesNoPlease phone us on 01603 626904 as this will need to be agreed in advanceI confirm that the Association/Club and students are Current members of the EKF and that the information Provided is correct at the time of submission* I confirm I have read, understood and agree to your terms & conditions* I agree Read our Terms & Conditions Credit Card* American ExpressDiscoverMasterCardVisa Card Number Month010203040506070809101112 Year20202021202220232024202520262027202820292030203120322033203420352036203720382039 Expiration Date Security Code Cardholder Name EmailThis field is for validation purposes and should be left unchanged.
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