Dependant Student Registration Please fill out the form below Status: My child is still a full-time student, and I will complete the form below.My child is no longer a student, but I would still like to keep them on our family cover. I will fill in my details to receive a call back.My child is no longer a student and can now take out their own cover. I will fill in their details so they will receive a call back. Confirm your child's dependent student registration Please complete this form as soon as you can so we’re able to update your membership. If we don’t hear from you, we’ll assume your child is no longer a student and they will be removed from your family’s health cover. Unfortunately, this means they’ll no longer be covered by rt health and they may need to re-serve waiting periods again on rejoining. Main member's details (this is the person in whose name the cover is held) Given Name * : Family Name * : Date of birth * : Calendar DD/MM/YYYY Member date of birth Membership Number * : Dependant student details Student Given Name: Student Family Name: Student date of birth: Calendar DD/MM/YYYY Student date of birth Contact number: ( ) - Second three digits Last four digits Your child is eligible to remain covered as a dependent student This registration will remain in place until 28 February 2023. We will contact you before this date to confirm that your child is still eligible to be covered as a dependent student. Name of school / college / university being attended: Is your child due to complete their course of study this year or cease being a full-time student this year: Yes No What is the expected date of completion or ceasing full-time study: Calendar DD/MM/YYYY Would you like your child to receive their own rt membership card: Yes No Would you like your child to sign claims on their own behalf: Yes No If yes, you are authorising your child to make claims on the membership without the need for your signature. Declaration I understand that if my child leaves full-time study, or becomes Married/de facto, he/she will no longer be eligible to remain covered as a dependant student. I understand that rt health reserves the right to verify my child's eligibility for cover as a dependant student. I will notify rt health fund if there is any change in my child's circumstances that affects his/her eligibility to remain covered immediately. I confirm that my son/daughter meets the student criteria which is: enrolled as a full-time student at an approved Australian school, college or university, and financially dependent on the family (the main member or partner of the main member), and not married or living in a de facto relationship. Please note, part-time students and apprentices are not eligible for cover as dependant students. Please also note that if at any time the eligibility as a dependant student ceases you need to contact us to make other arrangements if continuing health cover is required. Please also note that cover for a dependent student will cease from the date they ceased to be eligible and no claims by them will be covered from that time unless you have made new arrangements to cover them under an extended policy. I've read and agree to the above terms and conditions and confirm the information I've provided is correct.