Student Animal Science Enrollment Form

STUDENT ANIMAL SCIENCE ENROLLMENT FORM

Student Information

Student Name:

Parent / Guardian Information (if student is a minor)

Program Enrollment Details

Select intended program track(s):

Livestock Management    Companion Animal Care    Veterinary Assistance    Research Methods / Lab    Equine Science

Program Start Date:

Expected Completion Date:

Payment Plan: Full payment    Installments    Scholarship / Aid applied

Emergency & Medical Information

Tetanus immunization date (if known):

Health & Safety, Assumption of Risk, and Consent

I acknowledge that participation in Animal Science coursework and field activities involves exposure to animals, biological materials, equipment, and conditions that present risk of injury, allergic reaction, zoonotic disease, or exposure to hazardous substances. I certify that the information provided above is true and complete and that I will disclose any change in medical status that could affect safe participation.

By checking the box below I release and hold harmless the institution, its instructors, staff, volunteers, and partnering facilities from liability for injury, illness, or property damage arising from normal or inherent risks of the program, except where caused by gross negligence or willful misconduct. I further agree to follow all safety procedures, animal handling protocols, and personal protective equipment (PPE) requirements established by the program.

I acknowledge and accept the health and safety terms above.

Field Work & Animal Handling Authorization

Field trips, farm visits, and supervised animal handling are required components of many Animal Science courses. Participation may include lifting, restraining, transporting, and direct contact with animals and animal waste. Students must complete required safety orientation and training prior to direct animal care activities.

I consent to participate in supervised animal handling and field activities.     I consent to transport of animals or to travel with program staff for off-site activities.

Students are responsible for providing required PPE when specified. The program may supply PPE in limited circumstances.

I agree to comply with PPE requirements and to follow program safety instructions.

Academic Policies & Conduct Acknowledgment

Enrollment in the Animal Science program is subject to standard academic policies including but not limited to attendance, grading, academic integrity, and safety training prerequisites. Failure to comply with conduct rules or safety protocols may result in removal from practical activities, course failure, or other disciplinary action.

I have read and agree to comply with the academic and conduct policies applicable to this program.

Fees, Refunds, and Financial Responsibility

The student is responsible for all tuition, course fees, laboratory fees, and costs associated with required materials. Deposits and certain fees may be non-refundable. Withdrawal or dismissal does not necessarily relieve financial obligation for tuition already earned or costs incurred by the program.

Photo, Video, and Record Release

The program may record instructional activities for educational, quality assurance, or promotional purposes. Personal information and images will be used in accordance with institutional privacy policies. By checking the box below, you grant permission to use non-sensitive images or recordings of the student for program purposes, unless you decline.

I consent to non-sensitive photo/video use as described.     I do not consent to photo/video use.

Additional Information

Certification

By signing below, I certify that the information provided on this form is true and complete to the best of my knowledge. I agree to abide by program rules, safety requirements, and financial obligations. I authorize program staff to obtain emergency medical treatment if I am unable to provide consent at the time of an incident.

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