Collegiate Care J1 Visa

Note: If you are a citizen of multiple countries, and one of them is United States, you must answer yes to the question above.
US Citizens are ineligible to purchase this coverage.
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  1. 15.0 SUBSCRIPTION AGREEMENT I hereby apply to be an Insured Person of the AMD Global Trust established in the Cayman Islands (the "Trust") and to participate in the insurance coverage extended by Zurich Insurance Europe AG, Belgian branch (the "Insurer") to Insured Persons under the Trust (the "Coverage"). I understand that the Coverage is not a general health insurance product but is intended for use in the event of a sudden and unexpected event while traveling outside my Home Country (for purposes of this Agreement, Home Country means the country from which the Insured Person holds a passport. In the event that a citizen of the United States holds more than one passport, the Home Country will be the country declared to in writing as their Home Country). I understand that the Coverage extended to me will terminate upon my return to my Home Country unless I qualify for a Benefit Period or Home Country coverage. I understand that I may obtain full details of the Coverage by requesting a copy of the master policy from the Plan Administrator. I understand that the liability of the Insurer as underwriter of the Coverage is as provided in the master policy. By acceptance of Coverage and/or submission of any claim for benefits, the Insured Person ratifies the authority of the undersigned to so act and bind the Insured Person. The Insured Person undertakes to make all Premium payments as they fall due in respect of the Coverage extended. AMD Global Trust (the Trustee ) shall not be responsible for the administration of such payments. If the Insured Person fails to make any Premium payment due in respect of the Coverage extended, subject to the discretion of the Insurer, such Coverage will lapse. The Insured Person hereby confirms the accuracy of all information and validity of all representations and warranties provided to the Trustee in connection with its participation in the Plan and/or the subscription for the insurance coverage, howsoever provided, including the terms of this Subscription Agreement, (together "Representations & Warranties"). The Insured Person acknowledges that certain of such information will be relied upon by the Insurer as Provider of the Coverage and that any inaccuracy therein may result in the invalidity of such Coverage as it relates to the Insured Person, the loss of Coverage and all monies paid in relation thereto. The Insured Person hereby undertakes to inform the Trustee of any change to any matter that forms the subject of any of the Representations & Warranties. The Insured Person hereby undertakes to indemnify and hold harmless the Trustee against any loss or damage (including attorney's fees) occasioned by any inaccuracy in any Representations & Warranties or failure to advise the Trustee of any change in any matter that forms the subject of any of the Representations & Warranties. The Insured Person agrees that the Trustee shall be entitled to rely on and to act in accordance with any written instruction purported to be provided by the Insured Person and the Insured Person hereby undertakes to indemnify and hold harmless the Trustee against any loss or damage (including attorney's fees) occasioned by the Trustee acting in accordance with any such instruction. Payments under the terms of the Coverage shall be paid by the Insurer to the Insured Person or directly to a Provider if assignment of benefits has been authorized. The Trustee shall not be responsible for the administration of such payments. I confirm that I have satisfied myself that the Coverage is appropriate for me and that I meet the Eligibility criteria. 
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