CircusFormTest

Get a quote

Registering is so simple and takes just a couple of minutes.

Title

First Name

Last Name

Telephone

Date of birth

House Name / Number

Postcode

Is your correspondence address the same Yes No

Correspondence House Name / Number

Correspondence Postcode

Cover start date

Make and model of Bike

Date of purchase

Type of bike

Value of bike

Store Location

Your Data

The personal data you provide us within these questions will be retained to provide you with details of our insurance services. If at any time you want your data removed from our systems please let us know. Our privacy notice lets you know how we look after your data.

Keep you informed

In order to help you get the most out of your relationship with us we would like to keep you informed about products, services, discounts and rewards that we think you'll find interesting. Please let us know how you want to hear from us (optional)

Options Email Phone Sms Post

Please read and accept the declaration below in order to activate the cover

Declaration

I am a UK resident, aged 18 years & over, and all the information provided is correct – any incorrect details could invalidate a claim.
I have purchased this bike from Evans Cycles, within the last 7 days, and have not previously registered this bike for free insurance with cycleGuard.
I confirm that I have not previously held any free cycle insurance cover with Cycleguard.
I have not had more than 2 cycling related claims within the last 3 years; nor had any type of insurance declined, cancelled or had special terms imposed.
I have not been convicted of any criminal offences (other than motoring offences).
understand I may be contacted by cycleGuard & provided with the option of a 12 month cycle insurance policy.

I confirm and accept the above declarations

Please read through these documents to familiarise yourself with the cover offered.

I have read, understood and agree to the terms and conditions shown in the policy documents