Please enable JavaScript in your browser to complete this form.Insurance Cover *Comprehensive CoverThird Party Only CoverThird Party, Fire, Theft and Transit CoverTyre & Rim CoverName *FirstLastAddressAddress Line 1Address Line 2CityState / Province / RegionPostal CodeEmail *PhoneBike Manufacturer *YamahaOtherBike Model *Bike Year Model *Value to Insure *Date of Birth *Gender *MaleFemaleConsecutive Years Motorcycle licence held *If less than 1 year please put 0Storage Method *Street ParkedGaraged (Home)Shared Cark ParkLockable BuildingHome AddressWill there be any OTHER rider under the age of 25 using the vehicle? *YesNoIn the last 5 years have the following applied to you?In the last 5 years had any insurance refused or cancelled? *YesNoIn the last 5 years suffered any motorcycle or theft insurance claims? *YesNoIn the last 5 years been charged of convicted of any offence (other than vehicle/motorcycle offences) *YesNoIn the last 5 years ever had your motor vehicle or motorcycle license suspended or revoked for any reason? *YesNoIf answered "Yes" to any of the above, please give a brief description of when/ date and how it happened.Privacy PolicyBy ticking the box you you agree that you have read and agree to YMI’s Privacy Policy. We value your privacy and have a Privacy Statement telling you about how we handle personal information collected for this insurance. We will send it with your quote; However, you can read it now if you want. Privacy Policy. You also agree that Trooper Lu’s Garage will use your information for marketingSubmit