This medical/support services information is being collected so that appropriate health care plans/educational services may be
developed and may be necessary to obtain funding. This information will only be shared with appropriate individuals. This information
is protected by the Personal Health Information Act and the Freedom of Information and Protection of Privacy Act. Questions should
be directed to the school principal.

I/We have received a copy of the PCAA Handbook and have agreed to the admission procedures and
other rules, policies and requirements described within. If my/our son/daughter named above is accepted for enrollment at PCAA, I/We:

a. agrees to be responsible for the fees and expenses as outlined in the PCAA Handbook; give permission for my/our son/daughter to go on field
trips (no longer than one school day) with the classes at PCAA during the school year. I understand that I will be notified by correspondence
sent home with my child of each upcoming field trip and costs involved.

b. authorize the school to send, upon request, the permanent records to the next school to which my child may enroll and to receive such records from another school.

c. agree to co-operate with the school in promoting the philosophy and principles of conduct as outlined in the PCAA
Handbook.

d. certify that all the above statements in this application form are true and correct to the best of my knowledge, knowing that willfully
withholding or misrepresenting information may result in refusal of admission or of dismissal from the Academy

I agree with the principles of conduct in practice at PCAA. By enrolling at PCAA I will endeavor to learn to serve both God and man. This school program is one I believe in and feel I can support. If accepted, I hereby agree to obey the regulations of the school and to cooperate with the faculty, staff and administration in upholding the standards of the institution outlined in the PCAA Handbook and as announced by administration, and to make PCAA a positive experience for all.

The computer network system is owned by the school. These rules will help us to be fair to others and keep everyone safe.

1. I will only use my own network login and password.

2. I will not look at, change or delete other people’s files.

3. I will not bring in my personal software, laptop or personal digital devices for attachment to a computer without permission. I will also not use
these devices during a class.

4. I will ask permission from my homeroom teachers before using a computer and before accessing the Internet.

5. I will tell the teacher if I see a problem with any computer.

6. I will not download software from the Internet nor distribute obscene and copyrighted materials over the network.

7. I understand that games should not be played in class. During free time a student may play educational games with the permission of their teacher.
If while permitted to play a game, a student must yield the computer to another student who would like to use it for legitimate work.

8. I understand that laptops are the school’s property and are not allowed to be taken home or used outside the school building.

9. I will not give my address or phone number online.

10. I will only send e-mail to people who my teachers have approved.

11. I will be respectful of the feelings of other users.

12. I will not use Internet chat unless supervised by a teacher for collaborative educational use.

13. I will tell a teacher immediately if I see anything I am unhappy with or if I receive messages I do not like.

14. I understand that the school may check my computer files and the Internet sites I visit.

15. I understand that if I deliberately break these rules, I may not be allowed to use the computers or the Internet.

16. I will not shoot and or publish photographs of the school, students and teachers without first obtaining their permission.

17. I will not eat or drink while operating a computer at PCAA.

18. I will handle all computers with respect and care.

19. I will promptly return a laptop to the mobile cart for charging after I have used it.

20. I understand that if I deliberately break any of these rules, I may not be allowed to use the computers or the internet at PCAA.

The school may exercise its right to monitor the use of the school’s computer network systems, including access to web-sites, the interception of e-mail and the deleting of inappropriate materials where it believes unauthorized use of the school’s computer system is or may be taking place, or may be used for harmful or criminal purposes or for storing harmful, unauthorized or unlawful text or
imagery.

The Personal Information Protection and Electronic Documents Act requirement with regards to disclosure of private information requires Prairie Central Adventist Academy to obtain your consent via this "Image Release and Consent" form.

We hope that this form will make it easier for you to make your decision about the use of your child's photo or other images. PCAA thanks you in advance for your cooperation.

If you do not return this form, PCAA will assume that you give us permission to use your child's image in PCAA’S publications, including yearbooks, brochures, handbooks, calendars, photographs, videotapes and the Internet.

Please understand that by not returning this form, you hereby remise, release, and forever discharge PCAA from any liability for any injury or action against the below-named student resulting from the use of such photographs, videotapes, or other images in any medium used by the school.

This release includes that PCAA will not be responsible for other Internet users' reproductions, displays, distributions, or modifications of students' images used, in whole or in part, in obscene, pornographic, or any manner, or will the School be responsible for, among others, the copyright infringement, defamation, misrepresentation, criminal acts, cyber theft, cyber stalking or other citizens' use of the School's website images and information.