Insurance Form

Please check the Travel Info section for details on travel insurance. Fields marked with an * are mandatory.

Name*
FirstLast
Waiver of Liability and Release Agreement
Please read and sign the Waiver of Liability and Release Agreement sent to you by mail, and upload a scan to this site.
File*
Possible formats: *.doc *.pdf allowed file size: max. 2MB
Insurance Coverage Confirmation
Please enter the relevant data, and upload a scan of your insurance coverage.
Insurance Company Name*
Policy Number*
Emergency Hotline of Insurance Company (inlcuding all area codes)*
File*
Please upload the valid insurance policy. Possible formats: *.doc *.pdf allowed file size: max. 2MB
Read before you submit
Please double check your information, since it will directly be forwarded to the local coordinator. Should you have any questions at this point please contact Philipp Schöffmann at p.schoeffmann(at)inex.org.
By checking this box and submitting your information through this page you confirm that you have read and understood the Waiver of Liability, Release Agreement and INEX General Terms, and that you have procured valid and sufficient insurance coverage for your stay and travel to the INEX program.*
- I Agree
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Waiver of Liability and Release Agreement