Insurance Application Form for AFF Course

Name (one name)

Please provide your data for the insurance purpose. It will be exactly the same on the insurance document, as you write it here, so make sure not to make mistakes, which may affect the insurance validity.

Last name (one last name)

Your nationality is:

🇷🇺Russian, 🇺🇦Ukrainian, 🇧🇾Belarusian
None of the above

You declare that the person listed does not hold citizenship of any of the following countries: Russia, Belarus, or Ukraine.

YOUR ID DOCUMENT NUMBER (If you are Polish citizen, please write PESEL)

☢️ ATTENTION:
IT MUST BE YOUR CORRECT ID NUMBER
(MUST MATCH YOUR OFFICIAL DOCUMENT)

If you make a mistake, enter only zeros — your insurance is NOT VALID
and we don’t take responsibility for it.
We don’t check nor correct what you input.

👉 The field requires 11 characters: if shorter, zeros will be added at the beginning; if longer, extra characters will be deleted. This does not affect your insurance validity.

Your ID Document is:

Passport
National Identity Card
PESEL

Postal code

👉Only letters and numbers. No spaces nor dashes.

City

Country

Street

House nº

Flat nº

Email:

Confirm Email

Custom Captcha

✅ Your data is safe

The personal data provided in this form is used only for the purpose of preparing the required documentation for your AFF course, including third-party liability (OC) insurance.
Skydive Atmosfera does not store this data or use it for any other purpose.
⚠️ I understand that I am responsible for the accuracy of the data I provide. Incorrect information may invalidate the insurance, and Skydive Atmosfera is not liable for consequences.