INSTRUCTION

Please fill out all required information on this form, to the best of your knowledge, and print your name and sign each page to confirm acknowledgment of the information given to you and provided by you.

Please thoroughly read the information on this form, and sign it to confirm acknowledgment of the information given to you and provided by you.

NURSING ASSISTANT PREPARATORY TUTORIAL

I understand that the Certified Nursing Assistant (CNA) Prep courses are offered to me by Alive Multi Services LLC to assist me in my preparation for the Florida CNA State examination. I fully understand that only Alive Multi Services Registered Nurses will administer these courses. The CNA Prep courses are designed for those who wish to challenge the Florida CNA State examination. The courses are privately owned and follow the State Department of Education Curriculum Framework for nursing assistant training. These courses can assist me in my preparation for the written and clinical skills needed to pass the Board of Nursing exam to become certified. The curriculum is subject to federal requirements and laws for individuals aspiring for nursing assistant training. I fully understand that it is my responsibility to purchase all required materials for the CNA Prep courses, including tuition fees, textbooks, an adult manual blood pressure cuff, a stethoscope, a wristwatch with second-hand, scrubs, scissors, clipboards, pads, black pens, pencils, highlighters, hand sanitizer, and the CNA registration fee. I also understand that Alive Multi Services LLC will not prepare or mail the application to the state Board of Nursing for licensure or registration. However, Alive Multi Services can offer assistance with completing the application per the client's request. Suppose I have any questions or concerns about the CNA test date and time after scheduling the exam; in that case, I am responsible for contacting the Florida Board of Nursing Customer Service Contact Center at 850-488-0595. Upon completing the CNA Prep Courses, Alive Multi Services will issue clients a Certificate of completion within 30 days.

Alive Multi Services Payment Plan Agreement ("Agreement") dated {date} is by and between {fullName} and creditor: Alive Multi Services LLC, with a mailing ADDRESS OF 3001 14TH Street West, Bradenton, FLorida, 34205, suite A. ("Creditor and Debtor: {fullName} , with a mailing address of {address33}.

Hereinafter the Debtor and Creditor agree to the following;

Balance: At the time of this Agreement, the Debtor owed the Creditor the amount of the service selected below.

In Consideration of the debtor's faith to repay the current balance in this agrement, the creditor agrees to:

No Discounted Balance
the Debtor shall pay the full current balance ('Amount Owed")
Any Amount owed must be paid in Full or $250/week only until fully paid

Please thoroughly read the information on this form. By signing this page, you hereby agree to abide by the conditions set forth herein. Payment Methods Accepted: Cash or Zelle to (910) 467 9954 or Via Alive's Website registration links.

Cancellation and refund policy for Alive Multi Services LLC 

Our CNA Challenge Prep will not refund any money paid if the applicant omits tutoring sessions for any reason, including when Alive Multi Services cancels a starting date. If the CNA Challenge Prep is terminated or postponed, or the client has an emergency, the client will be allowed to participate in the subsequent scheduled session. Alive Multi Services LLC charges an established registration fee of $100.00 to establish a client record system, which is non-refundable, a $150.00 for the Alive CNA Challenge Book, and a successive payment of $500.00 until full payment of $1500.00 is reached. I understand that a Certificate of Completion will be issued at the end of the CNA Challenge Prep upon receiving good grades in all assignments and skills exams. This will equip me with the necessary knowledge and tools to pass the State Board Examination. All fees and tuition must be paid in full before my first tutoring session. I understand that Alive CNA Challenge Prep cannot promise or guarantee employment of a client's success, and the only way to succeed in the State Board Examination is to put up the hard work and study, study, and study. I understand that at no time am I to be under any degree of influence of any illicit substances or intoxicants while on the premises.

In exchange for being permitted to enter the premises of Alive Multi Services (The Business), located at 3001 14th street west, Bradenton, Florida 34205, Suite A. (The Premises) to Nursing Bootcamp & Tutorial, I agree to the following as described in this contract. By printing your name, and signing this page, you hereby agree to abide by the conditions set forth herein.

The customer agrees to the instructions and requirements. I will follow all the business instructions while on the premises, including Alive Multi Services LLC guidelines and requirements. I agree not to enter the premises if I am experiencing symptoms of COVID-19 such as cough, shortness of breath, fever, loss of taste, headaches, have a confirmed or suspected case of COVID-19, or have come in contact in the last 14 days with a person who has been confirmed or suspected of having COVID -19.

I am aware of the highly contagious nature of COVID-19 and the risk that I may be exposed to or contract COVID-19 by being on the premises and engaging in the activity. I acknowledge that I am voluntarily entering the premises to engage in the activity with knowledge of the danger involved. I hereby agree to accept and assume all risks of personal injury, illness, disability, or death related to COVID-19 arising from being on the premises or engaging in the activity, whether caused by negligence of the business or otherwise. Customer Releases Business From Liability I hereby expressly waive and release all claims, now known or hereafter known, against Alive Multi Services and its owners, employees, affiliates, and officers on account of injury, illness, disability, or death arising attributable to my being on the premises or engaging in the activity and being exposed to or contracting COVID-19, whether arising out of the negligence of the business, it's owners, employees, affiliates, officers, or otherwise.