Annual Training Enrollment Form

ANNUAL TRAINING ENROLLMENT FORM

Participant Information

Participant Full Legal Name:

Date of Birth:    Student ID:

Emergency Contact & Medical Information

Training Program Selection

Select the training(s) for which enrollment is requested (check all applicable):

Workplace Safety

First Aid & CPR

Leadership Development

Technical Skills / Trade Instruction

Other:

Scheduled Start Date:    Scheduled End Date:

Payment Option: Full payment at enrollment    Installment plan    Employer-sponsored

Policies, Attendance & Acknowledgements

By signing below the participant or authorized guardian certifies that they have read, understand, and agree to the following terms. Each acknowledgement below is a material term of enrollment.

Attendance Requirement: Participant must attend no less than eighty percent (80%) of scheduled contact hours for certification of completion. Absences do not relieve financial obligations.

Make-up Policy: Make-up or remedial sessions may be offered at provider discretion; additional fees may apply. Provider is not obligated to offer make-up sessions beyond those listed in the program schedule.

Code of Conduct: Participant agrees to comply with all instructor and site rules. Disruptive or unsafe behavior may result in dismissal from the program without refund.

Media Release: Participant grants permission to the provider to record photographs or video during training activities for internal records, training quality review, or promotional materials, unless the participant withdraws consent in writing prior to the start date.

Confidentiality: Participant will protect confidential or proprietary materials provided during training and will not disclose such materials to third parties without express written authorization.

Cancellation & Refund Policy: Cancellations received in writing prior to the program start date may be eligible for a refund less any non-recoverable administrative fees. After the program start date, refunds are granted only at the provider's discretion.

Accommodations & Emergency Authorization

Does the participant require accommodation for a disability to fully participate in the training? Yes No

Emergency Medical Authorization: In the event of illness or injury during training, I authorize the training provider and its agents to arrange for emergency medical care as deemed necessary. I agree to be financially responsible for such care. I authorize emergency medical care as described.

Data Use & Privacy

The training provider collects and retains participant records necessary for certification, compliance, and funding purposes. Participant records may be shared with sponsoring employers or certifying bodies where required by program rules. The provider will maintain records in accordance with applicable institutional record retention policies.

Certification and Authorization

By signing below the signer certifies that all information provided on this form is true and complete to the best of their knowledge. The signer agrees to be bound by the policies and terms set forth in this enrollment form, consents to emergency medical authorization if indicated, and releases the training provider from liability for ordinary negligence to the fullest extent permitted by law. The signer further acknowledges financial responsibility for tuition and fees unless expressly waived in writing by the provider.

Authorization for Minor (if applicable)

If the participant is under 18 years of age, a parent or legal guardian must sign below. By signing, the parent or guardian affirms that they are authorized to enroll the minor and consent to all terms, policies, and emergency authorizations set forth in this form.

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