Coastline Regional Occupational Program (ROP)

PHYSICAL CONTACT AND GRAPHIC IMAGES CONSENT AND RELEASE AGREEMENT

This form pertains to instruction for certain Biotechnology, Emergency Response, Law Enforcement, and Patient Care career pathway courses and training programs. Please read, and acknowledge this form at the time of registration. The acknowledgment will be kept on file for one year.

1. I understand that participation in this course will require physical activity, including physical contact between students, instructors, or other participants. Such physical contact may be required for demonstrations and training activities. I consent to such contact as required for this course and/or state training program.
2. I understand that physical contact related to the course should not occur outside the presence of an instructor or a designated supervisor.
3. I understand that some units in this course may require the viewing of instructional or training videos and other materials containing graphic images, including, but not limited to: substantial bodily injury, human anatomy including reproductive systems, sexually transmitted diseases related to bloodborne pathogens, and similar images. I consent to the viewing of such images as part of this course and/or state training program.
4. Based on my full understanding and acknowledgment of the above statements, I agree to indemnify, hold harmless, and release Coastline Regional Occupational Program, its employees, officers, representatives, and students from liability related to my/my student’s enrollment and participation in this course.

PATIENT CARE TRAINING PROGRAMS CONSENT AND RELEASE AGREEMENT

This form pertains to instruction in certain Patient Care Career Pathway courses and training programs. Please read, and acknowledge this form at the time of registration. The acknowledgment will be kept on file for one year.

I understand that this course may require students to perform certain activities that include, but are not limited to: blood withdrawal, capillary puncture, injections, electrocardiograms, considerable standing, heavy lifting (50 lbs.), as well as repetitive hand and arm motions that may cause or exacerbate any pre-existing auto-immune, muscular, joint, cardiovascular, neurological and/or orthopedic conditions. Knowing the risks of such activities, I hereby agree to assume those risks and to indemnify, hold harmless, and release Coastline Regional Occupational Program; it`s employees, officers, representatives, and students from liability related to the student’s enrollment and participation in these Career Pathway courses and training programs.

STUDENT HANDBOOK ACKNOWLEDGMENT AND AGREEMENT

I acknowledge that I have not only read and understand the information found in Coastline ROP’s Student Handbook, but also agree to abide by all policies and procedures set forth by my school, district, and ROP. I understand that this signed form will be kept on file by my instructor for the school year.

STUDENT MEDIA AND PUBLICITY CONSENT AND RELEASE AGREEMENT

Coastline ROP is known for its high-achieving students, instructors, and programs and likes to publicize these achievements. Because events and interviews are often needed on the spur of the moment, we are requesting your permission to photograph or film students in advance.

Please check a box on the registration form indicating whether or not you permit Coastline ROP, and organizations, consortiums, and associations connected with it to represent the student named below, in photograph(s), video recordings, and with interview comments for use in educational, promotional, and publication purposes. These items may be distributed to individuals, groups, and the news media and published in, but not limited to, advertisements, catalogs, class schedules, news releases, newsletters, slide shows, video presentations, social media, and the Internet. The acknowledgment will be kept on file for one year.

STUDENT USE OF ELECTRONIC RESOURCES AND TECHNOLOGY AGREEMENT

Students may have access to ROP electronic resources and technology only if a signed copy of this agreement is on file. Instructors should keep this document on file for one year or longer depending upon the length or requirements of the training program. STUDENT CONSENT As a student of Coastline ROP, I acknowledge that I have read the ROP’s Acceptable Use Policy, understand that the ROP computer system is designed for educational purposes and will abide by the policy. I acknowledge that the ROP may review the electronic (email) files of messages sent or received using the ROP’s computer equipment or networks.

All students must understand and agree to the terms and conditions described above prior to registering for a Coastline ROP adult course. The acknowledgment of the above terms will be kept on file for each student.

STUDENT HANDBOOK CNA (Pre-Certification) Internship ADULT FEE-BASED COURSE