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I have read the literature describing the AIM Platinum Plan and also the AIM Gold Plan and hereby enroll my son/daughter in the following plan:

CHOOSE THE PLAN OF YOUR CHOICE

GOLD PLAN

MEDICAL COVERAGE in Israel for the full year

PLATINUM PLAN

ADVANCED MEDICAL COVERAGE in Israel for the year

*Please Note Required Fields

The information above does not excuse the necessity of submitting a Medical History form as required.
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I have read and agree to the Terms & Conditions of the AIM enrollment application. I agree to pay for all other medical and dental services incurred by the above named registrant, which services are not coveredby the terms and conditions of this agreement and by pressing SUBMIT below, request registration for my child on the AIM plan.