English Karate Federation Instructor Insurance EKF instructor Name of Instructor Applicant* First Last Name of Applicant's Registered Association/Club* Email* Phone*Postcode* Karate Dan Grade*1st2nd3rd4th5th6th7th8th9th10thCover required*£5,000,000 cover for £73.92, or £10,000,000 cover for £98.56 £5,000,000 £10,000,000 Start Date for Insurance* DD slash MM slash YYYY Activities are Karate only?*(cover excludes the use of live/sharp blades) Yes No Please phone us on 01603 626904 as this will need to be agreed in advanceAny previous claims?* Yes No Please phone us on 01603 626904 as this will need to be agreed in advanceI confirm I am over 18 years old* Yes No Please phone us on 01603 626904 as this will need to be agreed in advanceI confirm I have a valid and vetted DBS Certificate* Yes No Please phone us on 01603 626904 as this will need to be agreed in advanceI confirm I have a valid and current First Aid Qualification or a Qualified First Aider will be present at all times* Yes No Please phone us on 01603 626904 as this will need to be agreed in advanceI confirm that I am a member of the EKF and that the Information provided is correct at the time of submission* Yes No Please phone us on 01603 626904 as this will need to be agreed in advanceYour chosen Premium is: £ 0.00 Premiums include insurance premium tax at 12%I have read, understood and agree to your terms & conditions*Read our Terms & Conditions Agree Credit CardCard Details Cardholder Name CAPTCHAEmailThis field is for validation purposes and should be left unchanged.