Rotary Travel Insurance - Registration Form

Insured person

postal code, city, country
a copy of submitted data will be sent to this account

Payor details

Calculation of applicable fee

term of insurance in days (min. 31 days - € 40,30) by 1,30 daily rate
Latin America 26 €, overseas and Europe(non SEPA countries) 16 €, SEPA countries 2€
premium plus bank fees

Payment details

for easier payment processing please provide your bank's name
please provide the date when the transfer was performed