Cave Enrollment Application – The Yunion, Inc

General Information
Name of Parent/Guardian filling out this form*
Prefix First Last
Your Email Address*
How did you find out about The Cave of Adullam Transformational Training Academy (CATTA)?*
- Facebook
- Twitter
- Instragram
- Google Search
- Word of Mouth
Student Information
Youth's Name*
Please enter the full name of the child you would like to register for The Cave of Adullam program.
First Middle Last
School/District*
State & Zip Code where Student Resides*
State / Province / Region ZIP / Postal Code
Municipality and County of Residence*
Height*
Weight (lbs)*
Eye Color*
- Brown
- Hazel
- Green
- Grey
- Blue
Age*
NOTE: Applicants must be over age 5.
Please enter a number from 6 to 18.
Date of Birth*
MM slash DD slash YYYY
Grade Level in School*
Gender*
- Male
- Female
Ethnicity*
Select one or specify Other.
- African American
- White
- Hispanic
- Asian
Youth Lives With*
Select One or Specify Other
- Father
- Mother
- Step Father
- Step Mother

Parental Information: Father
Father's Name*
First Last
Father's Address*
Street Address City State ZIP Code
Father's Date of Birth*
MM slash DD slash YYYY
Father's Home Phone
Father's Work Phone
Father's Mobile Phone*

Parental Information: Mother
Mother's Name*
First Last
Mother's Address*
Street Address City State ZIP Code
Mother's Date of Birth*
MM slash DD slash YYYY
Mother's Home Phone
Mother's Work Phone
Mother's Mobile Phone*

Parental Information: Step Parents (if applicable)
Step Father's Name
First Last
Step Father's Address
Street Address City State ZIP Code
Step Mother's Name
First Last
Step Mother's Address
Street Address City State ZIP Code

Parental Feedback
Please rate your child's school and home performance in each of the following six areas.*
Horrible Poor Just OK Good Great Excellent
Academic Performance
Peer Relations
Family Support
Self Esteem
Parental Respect
Discipline
How would you like the Cave of Adullam to benefit your son (one sentence)?*

Student Feedback
This section is to be filled out by the potential student.
Are you a Christian?*
- Yes
- No
- I'm not sure
What year did you surrender your life to Christ?*
Did you get baptized?*
- Yes
- No
- I'm not sure
Do you read your bible?
- Yes
- No
How often do you read your bible?*
- Occasionally
- Often
Why do you not read your bible?*
Why are you interested in the Cave of Adullam?*
Have you ever studied a martial art?*
- Yes
- No
Which martial art(s) have you studied?*
How much of an influence do you have on your peers?*
Please check all the areas in your life that you need help with.*
- Lack of Focus
- Anger
- Absent Father
- Low Self Esteem
- Fear
- ADHD Symptoms
- Bullying
Please Explain why you need help with the areas you checked above.*
List three words that you would use to describe yourself.*
List three words that family or peers would use to describe you.*
Does your biological father live with you?*
- Yes
- No
How often do you see your biological father?*
What is your expectation from being enrolled in the Cave of Adullam?*
Check off nine (9) emotions below that you CURRENTLY experience DAILY.*
- Anger
- Peace
- Argumentative
- Gentleness
- Love
- Hostility
- Goodness
- Fits of Rage
- Jealousy
- Patience
- Hate
- Self-Control
- Joy
- Anxiety
- Faithfulness
- Sexual Desires
- Depression
- Kindness
- Envy
- Fear

Please read each statement carefully. If the statement is true for you most of the time, then place an dot next to ‘Strongly Agree’ box. If the statement is true for you some of the time, place a dot in the ‘Agree’ box. If the statement is false for you some of the time, then place a dot in the ‘Disagree’ box. If the statement is false for you most of the time, then place a dot in the ‘Strongly Disagree’ box. Your answers will not be shared with your parent/guardian. Thank you.*

	Strongly Agree	Agree	Disagree	Strongly Disagree
It’s difficult for me to remain still.
I have a quick temper.
I have a difficulty being quiet or relaxing.
I do not understand why God created me. (I do not understand my purpose)
I am easily distracted.
I often make careless mistakes.
It’s difficult for me to pay attention to details.
I do not understand the bible.
I have difficulty remembering and following instructions.
I am scared to die.
I feel like a loser in life.
I am easily intimidated by my peers.
I have a difficulty saying “no”.

You can now press NEXT for your parent or guardian to continue filling out this form.

Last Page
Parent or Guardian,
Thank you for your time and the time of your student in completing the answers.

On this final page, please review the below waivers.
Audio Visual Image Release Form

I grant permission to The Yunion Inc., the Cave of Adullam and its employees and agents, to take and use visual/audio images of my child. Visual and audio images are any type of recording, including photographs (class picture, training, field trips, etc.), digital images, drawings, renderings, voices, sounds, video recordings, audio clips or accompanying written descriptions. The Yunion Inc., the Cave of Adullam and its employees and agents will not materially alter the original images. I agree that The Yunion Inc., the Cave of Adullam and its employees and agents owns the images and all rights related to them. The images may be used in any manner or media without notifying me, such as The Yunion Inc. and the Cave of Adullam sponsored events, The Yunion Inc. and the Cave of Adullam websites, publications, news and media outlets, promotions, broadcasts, advertisements, posters, brochures and theater slides. I waive any right to inspect or approve the finished images or any printed or electronic matter that may be used with them.

I release The Yunion Inc., the Cave of Adullam Transformational Training Academy and its employees and agents, including any firm authorized to publish and/or distribute a finished product containing the images, from any claims, damages or liability which I may ever have in connection with the taking of use of the images or printed material used with the images.

By submitting this online CATTA application, I am indicating that I understand its content, and I freely accept the terms.
Waiver of Liability Form

I give permission for the student on this application to participate in The Cave of Adullam Transformational Training Academy. Although this program is mentoring focused, I agree and understand that martial arts training or strenuous exercise can be hazardous to some individuals and may result in injury or even death to the student or other students. Parent/Guardian and student further understands and agrees that all use of martial arts training equipment and conditioning aids shall be at the student's sole risk. Notwithstanding, any consultation on martial arts training which may be provided by The Yunion Inc., The Cave of Adullam, its' instructors, it is herby understood that the parent/guardian and student agrees, submits and adheres to the selection of training methods, materials, philosophies and types of equipment used in The Cave of Adullam Transformational Training Academy.
Parent/Guardian and student further agrees that in consideration for permission to train in The Cave of Adullam Transformational Training Academy, the parent/guardian and student assumes all risks of injury incurred or suffered while on and/or upon the premises of the International Institute and releases and agrees not to sue the International Institute, The Yunion Inc., The Cave of Adullam and/or its instructors, agents, employees, servants, associations, contractors, or anyone connected with The Yunion Inc., The Cave of Adullam or the International Institute for any claim, damage, costs, or cause of action which student has or may have in the future as a result of injuries or damages sustained or incurred while training in The Cave of Adullam on and/or upon the premises of the International Institute. The Parent/Guardian and student also concur that the student has no pre-existing medical restrictions and is in good health.
By submitting this online CATTA application, I am indicating that I have read these terms, understand them, and agree to abide by them.
Parental Signature*
- "By checking this box, I am electronically signing my application & acknowledge that I have read, understand, and consent to the above waiver of liability and audio/visual clearance release. I understand there may be additional paperwork for me to complete should I agree to go further in the process. I also understand that an electronic signature has the same legal effect and can be enforced in the same way as a written signature.
Comments
This field is for validation purposes and should be left unchanged.

Dear Prospective Parents,

Step 1 of 7

General Information

Student Information

Parental Information: Father

Parental Information: Mother

Parental Information: Step Parents (if applicable)

Parental Feedback

Student Feedback

This section is to be filled out by the potential student.

Last Page

Parent or Guardian,
Thank you for your time and the time of your student in completing the answers.

On this final page, please review the below waivers.

Audio Visual Image Release Form

Waiver of Liability Form

SHARE OUR CAUSE!

	Horrible	Poor	Just OK	Good	Great	Excellent
Academic Performance
Peer Relations
Family Support
Self Esteem
Parental Respect
Discipline