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Rock Climbing Travel Insurance Application

Looking to add cover for rock climbing or mountaineering?

Simply complete and submit the following online form. We will review your responses and will reply within 3 business days.

Insure4less is a trading name of Online Insurance Brokers Pty Ltd (ABN 21095612276) AFS Licence No 241055 of PO Box 167, Scarborough, Qld 4020. Online Insurance Brokers Pty Ltd is an Australian Financial Services Licensee and is authorised by ASIC to issue, deal in and provide general advice on general insurance products.

The advice provided by Insure4less is of a general nature only and does not take into account your financial situation, needs and/or objectives. You should read carefully the entire product disclosure statement to ensure that the policy is appropriate for you.

Your email address:
Confirm email address:
First name:
Last name:
Are you travelling within the next 3 days?	Yes No
Are you presently in Australia?	Yes No
Please indicate which level of cover you require:	Standard Plan: Includes sport rock climbing, bouldering and abseiling up to 3,500 metres (ASL) on previously graded and approved routes. Alpine Plan: Includes traditional and sport rock climbing, mountaineering, ice or glacier climbing, bouldering and abseiling up to 6,500 metres (ASL) on previously graded and approved routes.
Have you ever sustained an injury whilst climbing?	Yes No
Please provide full details of the accident/injury including dates/circumstances etc and advise if you are still receiving treatment or if now completely healed:
Have you had any previous Search and Rescue, Medical Emergency or Repatriation incidents whilst on previous trips?	Yes No
Please provide details of the Search and Rescue, Medical Emergency or Repatriation incident:
What is your maximum grade (Ewbank) of climb for this trip? (Rock climbing only)
How many years have you been regularly climbing at this grade?
Please provide details of any guides / instructors that will be accompanying you on your climbs and details of the proposed climb and if through a company the relevant page on their website for this trip:
Will you be climbing/trekking over 6,500 metres?	Yes No
Will your climb involve multi-stage ascents, professional guides or porters?	Yes No
Please provide full details of the proposed climbs, including information about the guiding company and acclimatisation programme:
What is the first date you'll be climbing?
What is the last date you'll be climbing?
Duration	Please choose dates above
Are you climbing in USA or Canada?	Yes No
What is your current age?
You acknowledge that you can only take out a climbing plan if you purchase a normal insure4less travel insurance policy for the full duration of your trip:	Yes No
Please confirm that you have read and understood the relevant climbing plan endorsement: Standard endorsement Alpine endorsement	Yes No
If you have any questions or wish to provide us with more information, please do so here: