Package 1

The following forms (Sample Form Package I) are intended to be used by institutions that do not provide accident medical coverage (or a similar insurance-type program) and that require students/parents to provide evidence of insurance coverage. The forms include a Sample Memo to parents as well as an acknowledgement of insurance requirements form.

PLEASE NOTE that the following forms are examples only, intended to assist institutions in the compliance process and are not required as a condition of compliance. These forms should be modified to meet the specific circumstances of your institution.

• Sample Memo to Parents
• Sample Parent Acknowledgement Form
• Sample Student-Athlete Acknowledgement Form

Package 2

The following sample form is for use by institutions that provide insurance coverage, but want to notify student-athletes/parents of potential uninsured expenses and/or provide information about your institution's insurance coverage.

PLEASE NOTE that the following form is an example only and is intended to assist institutions in the compliance process and are not required as a condition of compliance. These forms should be modified to meet the specific circumstances of your institution. Any information you intend to provide parents about the institution's insurance policy should be reviewed/approved by your insurance advisor.

• Sample Memo to Parents