Third Party Liability Insurance Parachutes/Hang Gliders ... Party Liability insurance for parachutes, non-motorised hang gliders and paragliders, valid worldwide (except USA), ... Hang Glider ! Parachute

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<ul><li><p> AXA Versicherung AG Versicherungsagentur fr Flugsport 6345 Kssen, Austria, Dorf 2, Telefon: +43-(0)5375-5314, Fax: 2160 Contact: Hedi Plangger, +43-(0)676-5112825, email: axa@fly-koessen.at </p><p> Third Party Liability Insurance Parachutes/Hang Gliders/Paragliders </p><p>(non-motorised, inclusive emergency rescue costs) Application according current General and special AXA-insurance Regulations </p><p> Insurance sums: Third Party Liability insurance for parachutes, non-motorised hang gliders and paragliders, valid worldwide (except USA), competition risks included </p><p> 1.500.000,-- </p><p>(at least) SDR 750.000,-- loss liability (without prior damage to property) 12.000,-- Emergency rescue costs resulting from accidents with the glider insured (personal rescue only) (please choose your option below) </p><p> 2.600,-- or 10.000,-- </p><p> ! Option with 2.600,-- insurance sum for emergency rescue costs Annual Premium (inclusive insurance tax) 70,-- Annual Premium for members of a NAC (inclusive insurance tax) 60,-- </p><p>! Option with 10.000,-- insurance sum for emergency rescue costs Annual Premium (inclusive insurance tax) 90,-- Annual Premium for members of a NAC (inclusive insurance tax) 80,-- Policy Holder Title, first name </p><p>surname </p><p>Address </p><p>post code, city, country </p><p>nationality </p><p>date of birth e-Mail-address </p><p>telephone - office telephone private fax </p><p>profession </p><p>! I am member of following NAC: </p><p>membership number: </p><p> Insured Glider (only solo gliders, no tandem) ! Paraglider ! Hang Glider ! Parachute Three gliders for personal use only may be on one policy. Only one glider at the time may be used. Type year of manufacture Serial number </p><p> Start of Cover: day/month/year </p><p> / / insurance period: </p><p>1 year Payment of premium: yearly by bank transfer </p><p>V 04/2014 </p><p> Place / Date </p><p> Signature </p></li></ul>

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