Declaration: Annual Multi-Trip Travel From UGM Magenta Ltd.

It is declared that:

All insured persons:

No insured person:

It is understood that there is no cover for any claims arising directly or indirectly from any medical condition suffered from or diagnosed:

Signed:_________________________

Name:_________________________

Capacity:_________________________

Date:_________________________

 

UGM Magenta Ltd | 112A Market Street, Chorley, Lancashire PR7 2SL | Tel: 0800 915 9225 | Fax: 08709 002389 | Email: travel@ugm.co.uk