sctrackguard Quoting Motorsport Track Guard

Type of Vehicle (Please note we do not quote for Bikes)

Car Other

Consent

Confirm you consent to us using your contact information to provide you with marketing information (you can unsubscribe from receiving these at any time)

Yes No

I/We agree that this proposal and declaration shall be the basis of the contract between me/us and the Insurer

Yes No

You consent to us using and securely storing your data, to share with Insurers, to enable us to find a suitable insurance product and quotation

Yes No

Policyholder and Driver(s)

Title

First Name

Surname

Date of Birth

Address

City

Postcode

Phone Number

Would you be interested in a quote for more than one track day in the next 6 months?

Yes No

Please enter details of all named drivers

How many track days have you/ the least experienced driver done in the last 12 months

None

1 - 4

5 or more

Driver 1 Name

Driver 1 DOB

Driver 2 Name

Driver 2 DOB

Driver 3 Name

Driver 3 DOB

Vehicle Details

Vehicle manufacturer / make

Vehicle model / type

What is the vehicle year of manufacturer

Registration and/or chassis number

Are you the owner of the vehicle

Yes No

How long have you owned the vehicle

Less than 12 months

12 months +

Not owned / Hired

What is the vehicle's market value (min £5,000. Values over £50,000 will be referred to the Underwriter)

Cover Required

What level (£ sum insured) is required to be covered? (Minimum £2,500 - Maximum £50,000)

What is the venue of the track day

What is the date of the track day

Please provide the event start time (xx:xx / 24hr format)

What is the duration of your track day

Full Day

Half Day (up to 4 hours in duration)

Weekend (2 days)

Please provide the event end time (xx:xx / 24 hr format)

Who is organising the track day(s)

If the Organiser is not on the drop-down, please enter them here

Declarations

Consent

Policyholder and Driver(s)

Please enter details of all named drivers

Vehicle Details

Cover Required