Download and Print an Enrollment Form

Download insuremykids® Application Form

(Adobe Acrobat Reader is required. Click here to download.)
  • Mail your application and Cheque or Money Order payment to:

    Reliable Life Insurance Company
    insuremykids®
    Box 557, 100 King Street West
    Hamilton, Ontario
    L8N 3K9

  • You may also fax your application (be sure to include your credit card number on the form) to 866-551-1704 (Toll Free)

Prefer to have an application mailed to you?

To have your insuremykids® application(s) mailed to you, please contact:

Reliable Life Insurance Company
insuremykids®
Toll Free: 800-463-KIDS (5437)

We're looking forward to hearing from you!

Underwritten by
Reliable Life Insurance Company
Box 557, 100 King Street West
Hamilton, ON, Canada L8N 3K9
Manitoba students and parents please refer to Manitoba Student Accident Insurance
for a description of plans and benefits for Manitoba.