Certification and Acknowledgement. Without limiting the applicability of any other State or federal law, by signature on this Contract, Contractor hereby certifies and acknowledges that:
Certification and Acknowledgement. By executing this Subscription Agreement, the Subscriber acknowledges and agrees to be bound by the terms and conditions of this Subscription Agreement, including all appendices hereto, and by the terms and conditions of any Offering Document (as defined herein). The Subscriber certifies that the information, representations, warranties, covenants and acknowledgements provided by the Subscriber in this Subscription Agreement, including all appendices hereto, are complete and true in all respects.
Certification and Acknowledgement. I certify that I have read this complete agreement and that my salary reductions do not exceed contribution limits as determined by Applicable Law. I understand my responsibilities as an Employee under this Program, and I request that Employer take the action specified in this agreement. I understand that all rights under the annuity or custodial account established by me under the Program are enforceable solely by me, my beneficiary or my authorized representative.
Certification and Acknowledgement. Employee certifies, acknowledges and agrees as follows:
Certification and Acknowledgement. The Representative certifies under penalty of perjury that all information he/she/it has provided to the Society regarding the Representative’s licensing and/or appointment application is complete, true, and accurate. The Representative further acknowledges that he/she/it has read and understands this Agreement and the attached Commission Schedule, has received a copy of both, and agrees to abide by and be bound to the terms as set forth therein and as may be amended by the Society from time to time in its sole discretion.
Certification and Acknowledgement. By signing this agreement, I certify I have read the above and I agree to abide by these requirements. I understand failure to fulfill my responsibilities as listed above can result in my dismissal from EOPS, cancellation of further services or other appropriate action as determined by the EOPS Program. This agreement is valid until I officially withdraw, graduate, transfer, removed, or pass eligibility limitations. I hereby authorize the release of information to EOPS from the informational resources of the college to determine my eligibility for the program and for monitoring my student conduct, academic progress, and program evaluation. Student Name (printed) Student Signature Student ID Date
Certification and Acknowledgement. Collect information about race & ethnicity for each participant & report the information annually. I certify that this Agreement has been explained to me by the Sponsor Representative. I also certify that this center is not currently participating in the Child Care Food Program. I understand reimbursement for meals claimed is provided through Federal Funds. I also understand that deliberate misrepresentation of program records or statements will subject me to prosecution under applicable State and Federal Criminal Statutes. I certify that this center will comply with all USDA requirements & the responsibilities outlined in the agreement. I agree to allow representatives of the sponsoring organization, CYFD & USDA to visit during normal hours of operation and inspect or review all areas and documents related to CACFP, attendance, enrollment and food service. ______________________________________________________ __________________________ Center Director or other Principal Officer Date On behalf of the sponsoring organization, I certify that I have explained this agreement to the center personnel listed above. As a representative of the Sponsoring Organization, I acknowledge that the Sponsoring Organization understands the expectations and agrees to comply with the rights and responsibilities outlined in the agreement. ______________________________________________________ __________________________
Certification and Acknowledgement. By signing this agreement, I certify I have read the above and I agree to abide by these requirements. I understand failure to fulfill my responsibilities as listed above can result in my dismissal from EOPS, cancellation of further services or other appropriate action as determined by the EOPS Program. This agreement is valid until I officially withdraw, graduate, transfer, removed, or pass eligibility limitations. I hereby authorize the release of information to EOPS from the informational resources of the college to determine my eligibility for the program and for monitoring my student conduct, academic progress, and program evaluation.
Certification and Acknowledgement. As a prerequisite to participation by my student in IHSA athletic activities, I certify and acknowledge that I have read this form and understand that my student must refrain from performance-enhancing substance use and may be asked to submit to testing for the presence of performance-enhancing substances in his/her body. I understand that testing may occur during selected IHSA state series events or during the school day. I do hereby agree to submit my child to such testing and analysis by a certified laboratory. I further understand and agree that the results of the performance-enhancing substance testing may be provided to certain individuals in my student’s high school as specified in the IHSA Performance-Enhancing Substance Testing Program Protocol which is available on the IHSA website at xxx.XXXX.xxx. I understand and agree that the results of the performance-enhancing substance testing will
Certification and Acknowledgement. As a prerequisite to participation by my student in UIL athletic activities, I certify and acknowledge that I have read this form and understand that my student must refrain from anabolic steroid use and may be asked to submit to testing for the presence of anabolic steroids in his/her body. I do hereby agree to submit my child to such testing and analysis by a certified laboratory. I further understand and agree that the results of the steroid testing may be provided to certain individuals in my student's high school as specified in the UIL Anabolic Steroid Testing Program Protocol which is available on the UIL website at xxx.xxx.xxxxxx.xxx. I understand and agree that the results of steroid testing will be held confidential to the extent required by law. I understand that failure to provide accurate and truthful information could subject my student to penalties as determined by UlL . Name (Print): Signature: Date: Relationship to student: Steroid Agreement 2012-2013 ATHLETIC CODE OF CONDUCT Pasadena Independent School District Revised 3/12 All Pasadena Independent School District athletes are subject to guidelines set forth in the Student Handbook Code of Conduct as approved by our Board of Education and Administrators. The handbook goes into great detail explaining Pasadena ISD’s policies concerning expectations of student conduct. Minor offenses, serious offenses, alternative education program offenses, expulsion offenses, teacher removal of students, suspensions, and miscellaneous offenses are all covered in the handbook. Consequences of violating school district policy are explained in the handbook. Any athlete violating these policies will be disciplined like all other students. In addition, he/she may be dismissed from the team or other privileges may be taken away at the discretion of the coach and administration. OTHER RULES OF CONDUCT FOR PASADENA ISD ATHLETES A student is not required to take part in athletics nor is it required for graduation. Participation in athletics is a privilege. Consequently, when high ideals and standards are violated, this privilege can be revoked. Pasadena ISD’s athletes will act with pride and dignity. On the Field or Court – The athlete must never use profanity or resort to illegal tactics. He/she must learn that both winning and losing are part of the game and that you have to exhibit good sportsmanship and be a gracious winner. Fighting, temper fits, flagrant violations of rules, etc., will not be tolerated. Tota...
