“Precious Moment’s” Terms & Conditions

The following information has been provided for the purposes of Seneca Group acting on my behalf to:

Register me for Sovereign’s ‘Precious Moments’ free $10,000 Life Insurance cover or To contact me following my due date for the same purpose

I acknowledge that:

· Seneca Group will hold my information under the terms of the Privacy Act for this purpose and may contact me regarding this offer or similar products or services

· Seneca Group will prior to registration provide me with a copy of the Terms & Conditions of Sovereign’s ‘Precious Moments’ offer so they may accept those on my behalf when registering me

· I may withdraw this authority prior to registration by contacting Seneca Group

I confirm that:

· I am the baby’s parent/legal guardian

· I am a New Zealand resident