• Martial Arts Insurance Quote Application

    Martial Arts Australia Insurance Services Pty Ltd ABN: 31 632 785 329 AFSR No: 001283262 Authorised Representatives of Marsh Advantage Insurance Pty Ltd - AFSL: 238369
  •  
  •  
  •  
  •  
  • DECLARATION
    I/We the undersigned duly authorised person(s) declare that:
    i. I am/we are authorised by each of the Proposers to sign this Proposal Form; and
    ii. the above statements are correct, true and complete; and
    iii. no information material to this Proposal Form has been withheld; and
    iv. I/we have read the important facts which you have put before me/us and I/we understand the advice given in relation to the duty of disclosure; and
    v. I/we have diligently made all necessary and detailed enquiries in order to comply with the duty of disclosure; and
    vi. I/we understand that no insurance is in force until such time as the insurer has confirmed acceptance of the proposed insurance; and
    vii. I/We undertake to inform the insurer of any material alteration to these facts occurring before completion of the contract of insurance; and
    viii. I/we acknowledge that the Insurer relies on the information and representations in this Proposal Form and otherwise made by me/us in relation to this insurance.

  • Clear
  • This application form will be used to create a letter of offer for the nominated insurances you have selected. Upon your acceptance of this offer we will create the rest of documents (invoice / certificate of currency etc)

    Payment Methods: Our invoice has all the payment options for you.

    Send all correspondence to: Martial Arts Australia Insurance Services
    Office: 6 / 12 Henderson Road, Knoxfield VICTORIA
    Postal: P.O Box 2057 Blackburn South VICTORIA 3130
    DISCUSS - P: 03 8201 9908  URGENT: 0451 331 958 (Text 24/7)

  • Should be Empty: