Insurance(s)
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Traveler Details
Name *
Address *
Country *
Date of Birth *
Date Format: DD slash MM slash YYYY
Nationality *
Passport Number *
Please choose an Insurance plan in order to proceed your payment
Number of additional travelers *
Additional traveler 1
Date Format: DD slash MM slash YYYY
Additional traveler 2
Date Format: DD slash MM slash YYYY
Additional traveler 3
Date Format: DD slash MM slash YYYY
Additional traveler 4
Date Format: DD slash MM slash YYYY
Additional traveler 5
Date Format: DD slash MM slash YYYY
Additional traveler 6
Date Format: DD slash MM slash YYYY
Additional traveler 7
Date Format: DD slash MM slash YYYY
Additional traveler 8
Date Format: DD slash MM slash YYYY
Additional traveler 9
Date Format: DD slash MM slash YYYY
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Ce champ permet d'afficher les informations ci-dessous. Il met fin à la section qui affiche ou non les additional travelers
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Your Summary
| Name |
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| Address |
City / |
| Date of Birth |
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| Nationality |
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| Passport Number |
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| Phone |
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| Email |
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| Country of Departure |
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| Country of Arrival |
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| Date of departure |
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| Return date |
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| Total |
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I accept that Insurte and its partners use my personal data to send me, especially by email, information on their products and services, according to our
Privacy Policy.
You have declared that you have read, before any agreement, the
pre-contractual information notice, the
insurance product information document (IPID), the Terms & Conditions, the
Terms of Service, the
Legal Notice, the
Privacy Policy, the
Cookies Policy, and the
Disclaimer. You agree that the entire purchasing process is online, including your consent and that you will not receive a paper version. You agree that this website is governed by the laws of the Republic of France, you must verify if the law of your country of origin or any other country that may apply to you forbids it, should this not be the case, cease this purchase and this session web. You have recognized that the guarantees, as described in the
Terms & Conditions, constitute a solution adapted to your needs and requirements. You have thus agreed to take out the Visa travel Insurance Contract and to authorize the processing of your personal data according to our
Privacy Policy.
You confirm that you have the legal capacity to contract.
You have declared that you have read, before any agreement, the
pre-contractual information notice, the
insurance product information document (IPID), the Terms & Conditions, the
Terms of Service, the
Legal Notice, the
Privacy Policy, the
Cookies Policy, and the
Disclaimer. You agree that the entire purchasing process is online, including your consent and that you will not receive a paper version. You agree that this website is governed by the laws of the Republic of France, you must verify if the law of your country of origin or any other country that may apply to you forbids it, should this not be the case, cease this purchase and this session web. You have recognized that the guarantees, as described in the
Terms & Conditions, constitute a solution adapted to your needs and requirements. You have thus agreed to take out the Visa travel Insurance Contract and to authorize the processing of your personal data according to our
Privacy Policy
You confirm that you have the legal capacity to contract.
You have declared that you have read, before any agreement, the
pre-contractual information notice, the
insurance product information document (IPID), the Terms & Conditions, the
Terms of Service, the
Legal Notice, the
Privacy Policy, the
Cookies Policy, and the
Disclaimer. You agree that the entire purchasing process is online, including your consent and that you will not receive a paper version. You agree that this website is governed by the laws of the Republic of France, you must verify if the law of your country of origin or any other country that may apply to you forbids it, should this not be the case, cease this purchase and this session web. You have recognized that the guarantees, as described in the
Terms & Conditions, constitute a solution adapted to your needs and requirements. You have thus agreed to take out the Visa travel Insurance Contract and to authorize the processing of your personal data according to our
Privacy Policy
You confirm that you have the legal capacity to contract.
You have declared that you have read, before any agreement, the
pre-contractual information notice, the
insurance product information document (IPID), the Terms & Conditions, the
Terms of Service, the
Legal Notice, the
Privacy Policy, the
Cookies Policy, and the
Disclaimer. You agree that the entire purchasing process is online, including your consent and that you will not receive a paper version. You agree that this website is governed by the laws of the Republic of France, you must verify if the law of your country of origin or any other country that may apply to you forbids it, should this not be the case, cease this purchase and this session web. You have recognized that the guarantees, as described in the
Terms & Conditions, constitute a solution adapted to your needs and requirements. You have thus agreed to take out the Visa travel Insurance Contract and to authorize the processing of your personal data according to our
Privacy Policy
You confirm that you have the legal capacity to contract.
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