The fields with asterix (*) are obligatory.
Policyholder's name*
NIE-number or passport number*
Address in Spain*
Postal code and city*
Telephone number*
E-mail*
Date of birth*
Profession*
Golf equipment description and value*
Where do you normally keep your accessories*
Do you have any claims in the last 3 years*
If yes, please give details of cause and amount
Are you a member of a golf club? Which?
Bank account number (IBAN) for direct debits
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Seguria S.L. 2024