第1页共31页编号:时间:2021年x月x日书山有路勤为径,学海无涯苦作舟页码:第1页共31页Declaration,TermsandConditionsAccidentSuranceDeclarationforAccidentSuranceI,onbehalfofeachofmyself,myspouseandmychild/children(ifany),herebydeclareasfollows:1
I(Insured)/We(Insured,insuredspouseandinsuredchild/children)herebyapplyforAccidentSurancewithintheHongKongSpecialAdministrativeRegionanddeclarethatthestatementsandparticularsgiveninthisapplicationaretothebestofmy/ourknowledgeandbelief,trueandcomplete,andthatthisapplicationwillformthebasisofmy/ourcontractwithAXAGeneralInsuranceHongKongLimited
I/Wefurtherdeclarethat:(i)Iam/Weareingoodhealthandfreefromphysicalimpairmentordeformity
(ii)Iandmyinsuredspousearebothunder60yearsofageandtheinsuredchild/childrenis/aresixmonthsofageoroverbutunder18yearsofageorisa/arefull-timestudent(s)ataschool,co