BodabodaCare Registration Form
Personal Information
Full Name:
Date of Birth:
Phone Number:
Email Address:
National ID/Passport Number:
Password
Confirm Password
Upload ID:
Upload Passport Photo:
Address Information
Residential Address:
City/Town:
Postal Code:
County:
Select Sub-County
Suna East
Suna West
Motorbike Details
Bike Make & Model:
Year of Manufacture:
Engine Number:
Chassis Number:
Motorbike Registration Number:
Upload Motorbike Images (3 images):
Please select exactly 3 images.
Insurance Plan
Coverage Type:
Select Coverage
>Accident
>Death
>Premium
Plan Duration:
Select Duration
1 months
6 months
12 months
Submit