Personal Accident Claim Form Application

    This form should only be completed if you have suffered an injury following competing in a NORA 92 sanctioned event and that you are the holder of either an annual ADVANCED or INTERNATIONAL licence issued by NORA 92 Ltd

    Please answer all of the questions in the form to assist us in processing your request and sending the claims form as quickly as possible.

    Injury Details

    Name of the licence holder injured:

    Riders licence number

    Rider E Mail address:

    Name of the organising club or organisation:

    Name of the Venue

    Event Start Date

    Please note the injuries sustained

    Contact Us

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