By submitting this application, I confirm that I ({name-1-first-name} {name-1-last-name}) am eligible to become a student as outlined above, and agree with all the information presented here. I hereby acknowledge my full commitment to cooperate with the rules and structure of the Adult & Teen Challenge BC program. I also understand that a breach of these rules and participation will subject me to disciplinary actions and/or dismissal from the program. Finally, I release my personal information to Adult & Teen Challenge BC, for internal use only.