Please complete your insurance registration first.

All coverage is subject to policy terms, conditions and exclusions. Click HERE to review a list of coverage and exclusions.

New Member Registration

Please complete all required information. If you have any questions, please contact support@getamsis.com or call (800) 530-0772.

Your First Name *

Your Last Name *

Address *

Address 2

City *

State/Province *

Zip/Postal Code *

Date of Birth? * +

Sex *

Male

Female

Phone Number *

Email Address *

Your Child's Registration

First Name *

Last Name *

Address *

Address 2

City *

State/Province *

Zip/Postal Code *

Date of Birth? * +

Sex *

Male

Female

Relationship to insured? *