Newly approved life insurance applicants are eligible for Cancer Guardian for the first year complimentary.
Individual Agent Name
Monthly Standard Program Charges
Monthly Program Charge
Under Age 40
Age 40 - 44
Age 45 - 49
Age 50 - 54
Age 55 - 59
Age 60 - 64
Age 65 And Over
Dependent Child Registration
Date of Birth
Printed Program ID Card
My mailing address is different than my billing address
Please review our terms and conditions here:
We are committed to protecting your privacy. We will only use the information that we collect about you lawfully. Any information you provide, particularly your email address, will never be sold or given to another source for any reason. We collect information about you for two reasons: first, to process your order and second, to provide you with the best possible service. We will not email you in the future unless you have given us your consent. We will give you the chance to refuse any marketing email from us or from another trader in the future.
The information we hold will be accurate and up to date. You can check the information that we hold about you by emailing us. If you find any inaccuracies we will delete or correct it promptly. The personal information which we hold will be held securely in accordance with our internal security policy and the law. We may use technology to track the patterns of behavior of visitors to our site. This can include using a “cookie” which would be stored on your browser. You can usually modify your browser to prevent this happening.
I have read and acknowledge that I am eligible for the Cancer Guardian program offer based on my recent life insurance policy approval through a LifeMark Partners contracted agency.
By submitting this registration form you are agreeing to become an active Cancer Guardian program participant.