I am not aware of any circumstances likely to lead to the cancellation of the journey nor have i withheld any information likely to affect the acceptance of this insurance and i will notify the company of any change in circumstances or health occurring
I declare that the purpose of this trip is not for therapeutic purposes
I declare i am in a good state of health fit to travel as confirmed by a qualified Medical Practitioner. Pre-existing conditions are excluded.
I accept the level of cover chosen.
Subject to terms and conditions of the policy wordings.
I hereby declare that the above representations are to the best of my knowledge true and should form the basis of the contract of insurance.