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Get the free Student-Athlete Information and Insurance Form - benfranklinhighschool

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This document collects essential information about student-athletes, including personal details, emergency contacts, and insurance information necessary for participation in sports.
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How to fill out student-athlete information and insurance

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How to fill out Student-Athlete Information and Insurance Form

01
Start by entering the student's full name at the top of the form.
02
Provide the student's date of birth in the designated field.
03
Fill in the student's address, including city, state, and zip code.
04
Include the student's contact number and email address.
05
Enter the name of the school the student attends.
06
Fill in the emergency contact information, including name, relationship, and phone number.
07
Provide details about the student's medical history, including any allergies and pre-existing conditions.
08
Complete the insurance information section, including the insurance provider's name, policy number, and contact information.
09
Sign and date the form to verify that all information is accurate.

Who needs Student-Athlete Information and Insurance Form?

01
Any student participating in athletics at a school or college.
02
Parents or guardians of student-athletes are required to fill out the form.
03
Coaches and athletic department staff may need the information for compliance and health purposes.
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Student-athletes may receive partial scholarships or full-tuition scholarships, room, board, and other benefits such as academic support and healthcare. Still, they are not paid in the form of a salary.
Personal professional sports insurance policies protect an athlete's future income in the event of a career-ending injury or illness. This can include permanent total disability, temporary total disability and accidental death and dismemberment coverage.
All schools with Division I sports programs must: Provide medical coverage for athletically related injuries for at least two years after graduation. Cover out-of-pocket medical expenses (copayments, deductibles, etc.) during a student-athlete's playing career.
Designated Team USA athletes are eligible to receive health insurance through the United States Olympic & Paralympic Committee's Elite Athlete Health Insurance Program (EAHI). EAHI is a preferred provider organization (PPO) plan.
These plans are considered blanket accident policies, which means the policy will pay for any services provided in the treatment of an intercollegiate sports-related injury, beyond what may have been paid for by the student's primary insurance, up to the medical maximum stated in the policy.
RELATIONSHIP TO PRIMARY INSURANCE All student-athletes are required to have primary insurance that covers intercollegiate athletics injuries (either through private insurance or via the member institution's intercollegiate athletics injury policy or self-insurance program) up to $90,000.

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The Student-Athlete Information and Insurance Form is a document that collects essential health, insurance, and contact information from student-athletes participating in sports programs.
All student-athletes who wish to participate in interscholastic or collegiate sports are required to file the Student-Athlete Information and Insurance Form.
To fill out the form, students need to provide accurate personal, emergency contact, and health insurance information, along with any medical history relevant to their participation in sports.
The purpose of the form is to ensure that student-athletes have adequate health insurance coverage and that schools are aware of any medical issues that could affect athletic participation.
The form must report information including the student-athlete's name, contact information, health insurance details, emergency contact information, and any pertinent medical history or conditions.
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