To make a claim complete the "Insured" portion of the appropriate form and have the "Attending Physician" (Doctor, Registered Physio or Athletic Therapist) complete the appropriate section. The "Club" section has mostly been filled out for you. Please complete the missing information.

Once you have completed the appropriate forms submit it with your ORIGINAL receipts to the address on the form.

If you have any questions email info@bikefernie.ca

Accidental Medical Claim (With Club section almost completed)

Accidental Dental Claim

Consent to collect, use and disclose personal information (Required for all claims)