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APPLICATION FOR SUMMER PROGRAM ADMISSION

APPLICATION FOR SUMMER PROGRAM ADMISSION

I hereby make an application for admission to Jones Technical Institute Project 212

JONES TECHNICAL INSTITUTE STUDENT WAIVER AND RELEASE FORM

This is a release. Please read carefully. Students must submit this completed form before registering for academic credit in the Automotive Technology, Diesel Technology or Commercial Truck Driving Program.

I,

am a student at Jones Technical Institute and plan to undertake study in the

Program at Jones Technical Institute (J-Tech).

In granting credit for this program, J-Tech affirms that, to the best of its judgment, all portions of the curriculum are appropriate curricular components required of students in its Automotive Technology, Diesel Technology and/or Commercial Truck Driving Program and worthy of credit.

Personal Conduct

I understand the responsibilities of the Automotive Technology, Diesel Technology and/or Commercial Truck Driving Program, and I indicate my willingness to understand and conform to the standards of the Automotive Technology, Diesel Technology and/or Commercial Truck Driving Program, including any physical requirements performed while in the labs.

I further understand that it is important to the success of the Automotive Technology, Diesel Technology and/or Commercial Truck Driving Program that students observe standards of conduct that would not compromise J-Tech in the eyes of any individuals with which it has dealings, and I acknowledge the Institute’s responsibility for setting rules and interpreting conduct for this purpose.

I further agree and understand that I remain at all times subject to the rules and regulations of Jones Technical Institute, including but not limited to the Code of Conduct published in the Jones Technical Institute Catalog. In addition, I understand that I am subject to immediate dismissal from the Automotive Technology, Diesel Technology and/or Commercial Truck Driving Program if I engage in violent or inappropriate behavior as determined by the Institute, or engage in the illegal use of drugs in any form while in the Program. I also understand that breaches of local laws will be referred to the appropriate law enforcement agency.

Medical Information

I have no known medical condition that would limit my participation in the Automotive Technology, Diesel Technology and/or Commercial Truck Driving Program. In the event such a medical condition arises, I understand that I must provide a referral from my primary care provider as a condition to my continued participation in the Automotive Technology, Diesel Technology and/or Commercial Truck Driving Program.

General Release

I understand that Jones Technical Institute reserves the right to make cancellations, changes or substitutions in cases of emergency or changed conditions or in the general interest of the Automotive Technology, Diesel Technology and/or Commercial Truck Driving Program.

On behalf of myself, my heirs, next of kin, personal representatives, successors, and assigns, I forever release Jones Technical Institute and/or its trustees, officers, administrators, employees, representatives, and/or insurers (the “Released Parties”) from any and all liability for claims, causes of actions, or damages arising from, resulting from, or in any way related to the Automotive Technology, Diesel Technology, and/or Commercial Truck Driving Program, including the Hands-On Training portion of the Program, and agree to waive any such claims that might arise, whether accruing now or in the future and whether now known or unknown, including but not limited to claims arising from the negligence of the Released Parties.

Assumption of the Risk

Jones Technical Institute does not knowingly approve “Hands On” training that pose undue risks to their participants. However, any “Hands On” training carries with it potential hazards, which are beyond the control of Jones Technical Institute and its agents or employees.

Miscellaneous

This Agreement will be governed by the laws of the State of Florida.

This Agreement contains the entire agreement of the parties about the subjects in it. It replaces all prior to contemporaneous oral or written agreements, understandings, statements, representations, and promises by either party. No supplement, modification, or amendment of, or to this Agreement will be effective and binding unless the same is contained in an express written agreement signed by me and a duly authorized representative of Jones Technical Institute.

This Agreement will be binding upon me and each of my heirs, executors, and representatives. This Agreement will inure to the benefit of the Released Parties and each of their heirs, executors, successors, assigns, and representatives.

Each provision of this Agreement is severable. Should any court or other tribunal of competent jurisdiction declare any provision(s) of this Agreement invalid or unenforceable by reason of any rule of law or public policy, all other provisions hereof shall remain in full force and effect.

I REPRESENT AND AGREE THAT I HAVE FULLY READ AND UNDERSTAND THE MEANING OF THIS AGREEMENT AND AM VOLUNTARILY ENTERING INTO THIS AGREEMENT WITH THE INTENTION OF GIVING UP ALL CLAIMS AGAINST THE RELEASED PARTIES.

STUDENT EXPECTATIONS

• I will arrive and be ready to begin class at the appointed start time. Arriving late or leaving early will affect my participation grade.
• I understand if I miss class, I miss critical hands-on learning. I am expected to maintain 95% or better attendance. Being absent will affect my participation grade.
• I will contact the school by calling 904-328-5600 if I will be late or absent. A message will be sent to my instructor.
• Out of respect for others, I will walk quietly in the hallways and not cut through the offices or classrooms. I will not enter the labs through the giant bay doors.
• In the event of fire or other disaster, I will evacuate the building and meet in the Northwest corner of the property near Suddath. If I am unsure of what to do, I will follow the directions of the nearest instructor.
• I will wear my uniform at all times. My coveralls will be zipped up at all times. I will wear closed toed safety shoes and safety glasses while in the labs.
• I will keep MY school clean by returning all furniture, tools, and equipment to their proper locations, keeping chairs pushed in and throwing away trash in designated receptacles.
• I will treat Faculty, Staff and other students with respect at all times. I will refrain from using obscene language while on campus. I understand that harassment of any sort will not be tolerated and is grounds for termination from school.
• In an effort to keep the classroom tables clean, I agree to wash my hands and arms prior to going into the classrooms.
• I will not sit on desks, counters, tool boxes, etc.
• I will keep my feet off the furniture.
• I understand that the kitchen located in the Community Room is reserved for school staff only.
• Proper hydration is a very important safety concern. Bottled water is permitted in all areas of the campus, but must be ‘capped’. I agree to consume food and other drink only in the student “brake room”.
• I understand that smoking is only permitted in designated areas. If I smoke, I will place all extinguished butts into the ashtray provided and not on the ground. Electronic cigarettes and chewing tobacco are not allowed in the building.
• I will park in the northern lot near the student entrance.
• I will use electronic devices such as cell phones and laptops responsibly. I will not text or play games in class or in the labs. I will not use headphones while on the backing range, in the labs or while class is in session. I will keep my phone on silent while in school.
• I understand J-Tech is a Drug Free School. I will not use drugs or alcohol while on school property. Due to safety reasons, I understand that if there is reasonable suspicion of drug use, J-Tech will call law enforcement and require me to leave the premises. I also understand that employers who hire J-Tech Students and Graduates, perform pre-employment and random drug testing. Using illegal drugs could result in me not getting hired.
• I will turn in my classwork and homework ON-TIME. I will not wait until the last minute to complete my assignments.
• I understand that the faculty and staff at J-Tech want me to succeed. I will ask for help if I need it.
• I will notify my instructor or a member of the Management team, if I have a concern. I will not spread negativity or gossip with other students.
• Most importantly, I agree to STAY POSITIVE AND HAVE FUN!!!

STUDENT EXPECTATIONS ACKNOWLEDGEMENT

I have read, understand, and agree to adhere to the expectation set forth by J-Tech.

Fitness Center Waiver and Release

Jones Technical Institute (J-Tech) offers student access to a Fitness Center that contributes to the life-long well-being of the individual student. The Fitness Center is equipped with contemporary aerobic, cardiovascular, and light weight equipment typically found in a modern gym or fitness center. The Fitness Center is open during business hours and is available to students during non-classroom hours and J-Tech welcomes the participation of our students in this important student service. The Jones Technical Institute (J-Tech) Wellness Program also offers instructional videos that contribute to an awareness of healthy lifestyles and provides informational seminars on health and wellness issues.

In consideration of my use of the exercise equipment and facilities provided by the Jones Technical Institute (J-Tech), I expressly agree and contract, on behalf of myself, my heirs, executors, administrators, successors and assigns, that the Institution and its insurers, employees, officers, directors, and associates, shall not be liable for any damages arising from personal injuries (including death) sustained by me, on, or about the premises, or as a result of the use of the equipment or facilities, regardless of whether such injuries result, in whole or in part, from the negligence of the Institute. By the execution of this agreement, I accept and assume full responsibility for any and all injuries, damages (both economic and non-economic), and losses of any type, which may occur to me, and I hereby fully and forever release and discharge the company, its insurers, employees, officers, directors, and associates, from any and all claims, demands, damages, rights of action, or causes of action, present or future, whether the same be known or unknown, anticipated, or unanticipated, resulting from or arising out the use of said equipment and facilities.

I expressly agree to indemnify and hold Jones Technical Institute, its parent organization Compass Rose Foundation, Inc. harmless against any and all claims, demands, damages, rights of action, or causes of action, of any person or entity, that may arise from injuries or damages sustained by me.

I agree to be solely responsible for my safety and well-being. I understand that the Institute does not provide supervision, instruction, or assistance for the use of the facilities and equipment.

I agree to comply with all rules imposed by the Institute regarding the use of the facilities and equipment. I agree to conduct myself in a controlled and reasonable manner at all times, and to refrain from using any equipment in a manner inconsistent with its intended design and purpose.

I understand and acknowledge that the use of exercise equipment involves risk of serious injury, including permanent disability and death.

I understand and agree that the Institute is not responsible for property that is lost, stolen, or damaged while in, on, or about the premises.

I understand that guests are not permitted to use the exercise equipment.

I understand and agree that my use of the facilities and equipment is only to be undertaken on my own personal time and that my use of the facilities and equipment is not within the course or scope of my class time unless directed by the program instructor.

I HAVE READ THE FOREGOING WAIVER AND RELEASE OF LIABILITY AND VOLUNTARILY EXECUTED THIS DOCUMENT WITH FULL KNOWLEDGE OF ITS CONTENT.

Media Release

I hereby grant to Jones Technical Institute the irrevocable and unrestricted right to use and publish written statements, photographs, video, and other recordings of me and/or my work, including all written statements, photographs, videos, and recordings in which I or my work may be included, for the purpose of promoting Jones Technical Institute and its programs. Furthermore, I agree to allow Jones Technical Institute in conjunction with their advertising agency(s) to make any necessary corrections to the written statements I have provided with regard to proper grammar usage. I hereby forever release and hold harmless Compass Rose Foundation Inc., Jones Technical Institute, and all their legal representatives and assigns from any and all claims and liability relating to or arising from the use of said written statements, photographs, videos, and other recordings. I understand that written statements, photographs, videos, and other recordings taken may or may not be published, at the sole discretion of Jones Technical Institute, and that I shall not, now or at any time in the future, be entitled to or seek compensation for the use of said images or recordings. It is my express intention that this release shall apply to my heirs and assigns now and forever for the sole benefit of Jones Technical Institute