You must be over 18 to claim. Please ask an adult to fill in this part if you are under 18.
Please note if you knowingly submit a claim previously awarded compensation you may be liable to prosecution under provisions of the 2006 Fraud Act
Use the eSignature box below to legally authorise Airclaim to handle your claim. Just press down on your mouse and draw, try to fill as much of the area as possible, and press clear if you make any mistakes.