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LICENCES
ANNUAL LICENCES
DAY / EVENT LICENCES
OFF ROAD LICENCES
FAQs
OFFICIALS
MEDIA
PERMITS
Event Info
INSURANCE
VEHICLE PASSPORTS
CONTACT US
ABOUT
NEWS
FAQs
CAREERS
Please complete the online application below.
Benefit Overview
The Flexible Insurance Options product overview can be found at the link below.
Please ensure that you have read this document thoroughly before apply for this additional cover.
FLEXIBLE INSURANCE OPTIONS OVERVEW →
Benefit Overview Declaration
*
I declare that I have read the Flexible Insurance Options overview and fully understand all aspects of this insurance product
Personal Details
First Name
*
Last Name
*
Mobile
*
Email
*
Current Application
This benefit increase application can only be applied to one valid licence.
Licence Type
*
Please select
Club Race Licence
National Race Licence
National Tarmac Rally Licence
National Gravel Rally Licence
Tarmac Rally Navigator Licence
Gravel Rally Navigator Licence
Extreme Event Licence
National Karting Licence
National Speedway Licence
Club Speedway Licence
National Drifting Licence
National Off Road Licence
National Off Road Navigator Licence
Club Off Road Licence
Licence Number for this benefit to be applied
*
Benefit Selection
The standard benefit provided is $900 per week. Please refer to the online insurance summary for additional details. This cover only applies for claims which occur at an AASA sanctioned event.
Please select the amount you would like this increased to:
*
$1,100 per week (cost is $500)
$1,300 per week (cost is $750)
$1,500 per week (cost is $1,000)
Increase weekly benefits to $1,100
*
Price:
$ 500.00
Increase weekly benefits to $1,300
*
Price:
$ 750.00
Increase weekly benefits to $1,500
*
Price:
$ 1,000.00
Total
$ 0.00
Declaration
*
I declare that all information provided for the purposes of this application is true and accurate to the best of my knowledge. I understand that in providing false or misleading information my licence may be suspended or cancelled, and I may not be afforded the coverage of the Personal Accident and Injury insurance provided under the AASA Insurance Scheme. I agree to comply with the AASA National Competition Rules at all times when participating in a AASA Sanctioned Event.
Credit Card
*
Card Details
Cardholder Name