September 1, 2015 Dear Parent(s)/Guardian(s): Re: Student Accident Insurance 2015-2016 Protect your kids—and your finances The Peel District School Board does not provide accident insurance coverage for student injuries that occur on school property or during school activities including extracurricular sports. Each year, many of our families spend thousands of dollars when their children are injured at school, on field trips, while participating in non-school activities, or at home. If a student is injured, parent(s)/guardian(s) are responsible for any costs not covered by provincial health care or their employer's health care plan. Please check with your provider regarding your coverage. The provincial health care system does not cover costs which are commonly related to accidents including dental work, ambulance fees, casts and crutches, and physiotherapy. All of these are covered by Reliable Life’s student accident insurance plan. To help protect your family, it is recommended that you consider obtaining student accident insurance. The insuremykids® Protection Plan is available through Reliable Life Insurance Company, which offers a variety of plans and benefits at affordable prices for as little as $8.00 per year. The enclosed application form provides details regarding rates and coverage plans. Family rates for three or more children are available even if they attend different schools in Peel. Additional savings are available with 3 Year and 5 Year Plans for on-line purchases prior to October 1, 2015. The insurance agreement is between You and Reliable Life Insurance Company. Please mail the application directly to them with your payment (no cash) using the self-addressed stamped application form. You can also apply for coverage directly online at www.insuremykids.com. For more information call Reliable Life Insurance Company toll free at 1-800-463-KIDS(5437) or visit www.insuremykids.com for answers to frequently asked questions. (over) Student Accident Insurance is recommended (but optional) for all students. STUDENT ACCIDENT INSURANCE NOTICE I/we have been made aware and fully understand that the Peel District School Board does not provide accident insurance coverage for student injuries that occur on school property or during school activities including extracurricular sports. This includes but is not limited to ambulance fees, crutches, casts, splints, rehabilitation, dental surgery or repair. I/we understand that the Peel District School Board does not require parent(s)/guardian(s) to purchase the insuremykids® Protection Plan through Reliable Life Insurance Company. Student accident insurance can be obtained through any provider. If a student is injured, parent(s)/guardian(s) are responsible for any costs not covered by provincial health care or their employer's health care plan. I/we further understand that my child will only be covered by insurance that I/we purchase, whether it is insuremykids® Protection Plan through Reliable Life Insurance Company, or appropriate insurance coverage through another insurance carrier or my employer’s benefit plan. I/we acknowledge that if my child is injured, I am/we are responsible for any costs not covered by either the insuremykids® Protection Plan, alternative insurance, provincial OHIP health care or an employer’s benefit plan. Student Name: ____________________________________________________________ _______________________________________ __________________________ Signature of Parent/Guardian or Student (if age 18 or older) Date __________________________________________________ Printed Name of Parent/Guardian or Student (if age 18 or older) Please complete this form and have your child return it to school