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Disclosure Notice Under the Financial Institutions Act
Province of British Columbia

The Financial Institutions Act requires that the information contained in this Disclosure Notice be provided to a customer in writing prior to the customer entering a financial transaction.

RE: Application for Insurance for Commercial General Liabilty? Program, Oasis Outdoor Adventure & Sports Insurance Solutions Inc.

  1. Oasis Outdoor Adventure & Sport Insurance Inc. is licensed as a general insurance agent by the Insurance Council of British Columbia.
  2. This transaction is between you and Lloyd's of London, Traveller's and Various MGA's.
  3. In soliciting the transaction described above, I am representing Oasis Outdoor Adventure & Sports Insurance Solutions Inc. which represents Lloyd's of London, Traveller's and Various MGA's.
  4. The nature and extent of my interest in Lloyd's of London, Traveller's and Various MGA's is none.
  5. The nature and extent of Lloyd's of London, Traveller's and Various MGA's interest in me is none.
  6. Upon completing this transaction, I will be remunerated by way of commission or other remuneration which will be paid to me by Oasis Outdoor Adventure & Sports Insurance Solutions Inc., the agency which I represent.
  7. The Financial Institutions Act prohibits Lloyd's of London, Traveller's and Various MGA's or me from requiring you to transact additional or other business with Lloyd's of London, Traveller's and Various MGA's as a condition of this transaction.

I have read the above terms and conditions and agree to proceed with the application.

Cycling Without Age (CWA) Application

Liability Application for Chapters of Cycling Without Age (CWA)


Please answer all questions fully. If a question does not apply mark it as "N/A" If there is not enough room to answer in the space provided please attach details.

  1. $

An accidental death and dismemberment policy can be arranged through Oasis if needed but is not included in this liability policy.

Home, Condo & Tenants liability insurance automatically protects against some personal use cycling liability coverage. Cycling Without Age Chapters will not have that cover therefore it is wise for clubs also apply for a Pedal Power policy on your bikes. This is also where physical damage coverage will be placed on your Trishaws


Where (a) an Applicant for this contract gives false particulars to the prejudice of the insurer or knowingly misrepresents or fails to disclose any fact in any part of this application required to be stated therein; or (b) the insured contravenes a term of the contract or commits a fraud; or (c) the insured willfully makes a false statement in respect of a claim, a claim will become invalid and the Insured's right to recovery is forfeited.

The Applicants have reviewed the contents of this application and acknowledge that all the information is true and correct and understand that this application for insurance is based on the truth and completeness of this information.

I have provided personal information in this document and otherwise and I may in the future provide further personal information. Some of this personal information may include, but is not limited to, my credit information and claims history. I authorize my broker or insurance company to collect, use and disclose any of this personal information, subject to the law and to my broker's or insurance company's policy regarding personal information, for the purposes of communicating with me, assessing my application for insurance and underwriting my policies, evaluating claims, detecting and preventing fraud, and analyzing business results. I confirm that all individuals whose personal information is contained in this document have authorized that I agree to the above on their behalf.

ABOUT OASIS Outdoor Adventure & Sport Insurance Solutions Inc.

OASIS Outdoor Adventure & Sport Insurance Solutions Inc. offers a national general liability program for accredited ATV, Off Road Trail Bikes and Snowmobile Safety Instructors while providing their courses.

Our specialties include, working with non-profit clubs, trail related exposures, outdoor adventure risks, large commercial, as well as standard line products.

For clients who own pedal bikes, ATV’s, UTV’s Dirt Bikes or Snowmobiles, go to to find a local broker.


OASIS Outdoor Adventure & Sport Insurance Solutions Inc.

10020 12th Ave
North Battleford, SK
S9A 3A4
Phone: 1-306-446-2747

Toll Free 1-866-979-2747
Fax 1-866-488-6122
Email contact form