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DECLARATION

We/I (Protected Athlete and/or Insured) declare that to the best of my/our knowledge, the statements made and particulars given in this application form are true and we/I have not misstated or suppressed any material fact.

We/I understand that non-disclosure or misrepresentation of a material fact may entitle Underwriters to void this insurance.

A material fact is one likely to influence acceptance or assessment of this application form by Underwriters: if applicant/named insured are in any doubt as to whether a fact is material or not they must disclose it in the corresponding space marked in application sections 1-3).