Paglia Training Center, LLC (hereinafter called “the Company”) does not discriminate on the basis of race, creed, color, religion, national origin, citizenship, age, gender, sexual orientation, disability, marital status, veteran status or any other status protected by law. The Company reserves the right to solicit information relative to your suitability for the training for which you are being considered.

To be in compliance with the New Jersey State law regulations regarding criminal history background check, the Company requires that all students enrolled in the Certified Home Health Aide training course obtain a Fingerprint/Criminal Background Check.

Please note that New Jersey State law provides that a person shall be disqualified from certification if that person’s criminal history record background check has not been cleared. This confirms that the Company reserves the right to drop such student from the class with no tuition funds refunded.

This application is for training and does not constitute an offer of employment. Eligibility for employment will be determined after an employment application is filed, an interview is performed, references are verified, and the interview process is successfully completed.

By signing below, I understand and accept the above requirements. I understand that omissions and/or misrepresentations made on the application form may be cause for my removal from training. I therefore certify that the information contained therein is true and complete to the best of my knowledge.

In consideration of being allowed to participate in training programs provided by Paglia Training Center, LLC (hereinafter called “the Company”) and/or in the use of its facilities and equipment where applicable, I do hereby waive, release and forever discharge the Company and all of its directors, officers, agents, employees, representatives, successors and assigns, and all others from any and all responsibility or liability for injuries or damages resulting in my participation in any training program activities. I do also hereby release all of those mentioned, from any responsibility or liability for any damage or injury to myself, including those caused by the negligent act or omission of any of those mentioned or others acting on their behalf, or in any way arising out of or connected with my participation in any of the contemplated activities or in the use of equipment through the Company or otherwise.

In witness whereof, the participant has executed this Express Assumption of Risk / Prospective Waiver of Liability and Release Agreement as of the date below, which shall be binding upon them and their respective heirs, executors, administrators and assigns. They also hereby further agree to indemnify and hold the Company and all those named or identified herein harmless in the event that anyone claiming any cause of action as a result of injury to participant attempts at any time to institute any claim or suit against the Company arising out of any of the activities or programs herein or in the use of any equipment.