Spring 2025 Practical exam Form

ACBSP™ Spring 2025 DACBSP® Practical Exam Registration: Initial & Retake Exams
  • Information
  • Education and Certificate information
  • Candidate and Certificant Agreement
  • Waiver of Claims Pursuant to Americans with Disabilities Act
  • Waiver of Civil Rights Act Claims
  • Payment

Information about your education & Information for your certificate

Candidate and Certificant Agreement

I understand and agree that, as a condition of qualifying for the ACBSP certification, I hereby accept the following terms and give the following releases. I accept and agree to satisfy the requirements of all current ACBSP policies, rules, and directives, including all requirements related to the ACBSP certification programs.

  1. I understand and agree that I will provide the ACBSP with accurate, complete, and current information, including the information in my Certification Application or Certification Maintenance Registration.  I agree to notify ACBSP in a timely manner of any changes concerning the information I have provided, including my current address, telephone number, and email address.  I understand that my failure to do so may result in the issuance of sanctions by ACBSP.
  2. ACBSP Rules. I understand and agree to abide by the ACBSP Bylaws.  I understand and agree to abide by the standards and rules in the ACBSP Code of Ethics and the Ethics Case Procedures.  I understand and agree to abide by the ACBSP Policy Manual.
  3. I understand and agree that consistent with applicable ACBSP policies, procedures, or instructions, the ACBSP has the unfettered right to:  suspend, condition, limit, revoke, or otherwise terminate my certification or certification eligibility, and any rights or privileges related to my certification.  Likewise, I understand that ACBSP has the right to suspend or terminate my examination administration and my examination score(s).
  4. I understand and agree that it is my responsibility to promptly notify the ACBSP of any legal, governmental, administrative, or organizational matters in which I am a named party, including, but not limited to:  lawsuits; administrative agency actions; professional disciplinary or ethics matters; malpractice claims; complaints related to my professional or business activities; and/or criminal charges or investigations. .  I have reported and fully disclosed to ACBSP all past and current ethics disclosure matters with my Certification Application or Certification Maintenance Registration.  I will report and fully disclose any such future matters to the ACBSP within ten (10) days of becoming aware or receiving notice of such matters.  I further understand that full disclosure requires the submission of all documents and materials related to ethics disclosure matters, and all materials required by the ACBSP.  I understand that my failure to satisfy these and any related requirements may result in ineligibility for the ACBSP certification, or other appropriate action(s), consistent with the ACBSP policies and procedures, up to and including expulsion and termination of ACBSP certification.

 

I understand and agree that if the ACBSP determines that additional information and/or documents are required concerning my compliance with the ACBSP Policies, I will provide a complete and accurate response to the requirements in a timely manner.  I understand and agree that my refusal or failure to provide proper responses to such information requirements may result in the issuance of sanctions by the ACBSP, up to and including expulsion and termination of ACBSP certification status. I understand and agree that the ACBSP has the right to communicate with any person, government agency, business, or organization concerning the information I submit to the ACBSP or which in any way relates to my ACBSP certification, including, but not limited to, information related to the ACBSP certification, or compliance with ACBSP Bylaws, rules, or regulations of any kind.  I agree to, and authorize, the release of any such information requested or required by the ACBSP.  Furthermore, I hereby irrevocably waive: (a) any and all objections to ACBSP requesting information and documents from any person or entity; (b) any objections to any person or entity producing records or information upon request from ACBSP; and (c) any claims I may have against ACBSP or any person or entity arising from the request or production of information or documents.

I understand and agree that all materials that I submit to the ACBSP become the property of the ACBSP, and that the ACBSP is not required to return any of these materials to me.

I understand and agree that, upon receipt of an ACBSP certification, all professional biographical data concerning me will be considered public information and may be made available to the public upon request.

I authorize the ACBSP to share, at its sole discretion, my name, examination score, pass/fail designation, aggregate data, and any additional information relating to my examination with the institution by which I completed my post-graduate training that qualified me for the certification examination.

  1. I understand and agree that certification by the ACBSP does not imply licensure, registration, or government authorization to engage in any professional or business activities, including chiropractic sports medicine.  I understand and agree that information related to my participation in the ACBSP Certification Programs may be used in a confidential, limited manner for research purposes only.  I represent and agree that the information I have provided to the ACBSP with respect to the ACBSP certification is accurate, complete, and current in all respects.  I understand and agree that my submission to the ACBSP of any false, misleading, inaccurate, or incomplete information can result in discipline or sanctions related to my Certification Application, or certification(s), including ineligibility, suspension, or revocation.
  2. Integrity of Electoral and Voting Processes: Candidate agrees to preserve the integrity and confidentiality of all electoral and voting processes associated with ACBSP.  Accordingly, I agree that, if I disclose unreleased polling data, voting/voter information, or other information in a manner that could affect the outcome of any vote or election, all my certifications, positions, offices, and titles will be immediately and summarily terminated, and I will be forever barred from identifying myself as a certificant or diplomate of ACBSP.
  1. Proprietary and Confidential Materials. I understand and agree that the contents of all the ACBSP examinations, examination information, and related test materials constitute confidential, proprietary, and private information and materials (ACBSP examination information), and the ACBSP owns and controls such examination information.  I understand and agree that my possession and review of any ACBSP examination information is for the sole purpose of taking a certification examination, and that no other person, business, or organization has any license or permission to view, receive, or use any such information.  I understand and agree that I am only permitted access to the ACBSP examination information for my personal, non-commercial use consistent with the ACBSP requirements and policies.  I will not disclose, discuss, share, distribute, reproduce, or otherwise disclose the content of the ACBSP examination information and materials in any manner.  I understand and agree that all of the foregoing applies to any materials that ACBSP designates as proprietary and/or confidential, that the right to make those designations belongs solely and exclusively to ACBSP, and that I have no right whatsoever to dispute those designations.
  2. I understand and agree that all disputes relating in any way to my Certification Application, my certification(s), and any ACBSP examination, or my adherence to ACBSP rules and regulations, including Bylaws will be resolved solely and exclusively by means of ACBSP policies, procedures, and rules, including the Certification Appeals Procedures.  I understand and agree that the ACBSP retains the sole and exclusive right and discretion to interpret and apply such policies, and to issue and enforce related decisions and actions.
  3. I understand and agree that the ACBSP is a private organization, and therefore, ACBSP certification is not akin to employment or any other right, nor is denial of certification an adverse action of any kind.  Furthermore, I agree that, by seeking and, if accepted, being granted, any form of ACBSP certification, I will not, obtain any property interest or other rights.  Likewise, my ACBSP certification does not constitute any type of fundamental right, or any right at all, for that matter.  Rather, ACBSP certification is a privilege that I seek in exchange for the express promise to adhere to ACBSP’s rules and regulations, without exception.  In light of the foregoing, I irrevocably waive all of my rights to pursue any “Claims” against ACBSP, which shall include, but not be limited to, all forms of: lawsuits; arbitrations; demands, causes of action; claims for relief; rights to redress; damages; orders; injunctions; writs; or appeals.  I hereby waive all Claims against ACBSP, regardless of whether they might arise from statute, common law, contract, tort, state or federal constitutions, any other law of any jurisdiction whatsoever, or in equity.  Additionally, I hereby waive any claims I may have arising in any way from any ACBSP examination, rule, policy, or procedure.
  1. Covenant Against Claims; Liquidated Damages. In furtherance of the foregoing waivers of Claims, I hereby covenant not to commence any Claim(s) against ACBSP at any type, for any reason, in any jurisdiction or venue whatsoever. I agree that any violation of this covenant would damage ACBSP, and that calculating said damages would be inherently difficult to calculate.  For those reasons, I hereby agree to pay ACBSP “Liquidated Damages” in the amount of twenty-five thousand dollars ($25,000) for any violation of this covenant. 
  2. I agree that the testing procedures offered by the ACBSP are sufficient to accommodate any disabilities I have. I hereby waive all claims against ACBSP related to any disabilities or testing accommodations, or lack thereof, whether arising from the Americans with Disabilities Act, or any other law relating in any way to disabilities and accommodations therefore.  Furthermore, I agree that ACBSP has no obligation to offer any accommodation of any kind, whether for a disability or otherwise.  Additionally, I understand and agree that this Agreement shall not be effective unless I contemporaneously execute Addendum No. 1 “Waiver of Claims Pursuant to Americans with Disabilities Act. 
  3. I hereby waive all claims under Title VII of the Civil Rights Act or any similar state level body of law. Furthermore, I agree that ACBSP is not a state, federal, or governmental entity at any level of government.  Additionally, I understand and agree that this Agreement shall not be effective unless I contemporaneously execute Addendum No. 2 “Waiver of Discrimination Claims.”    
  4. Limitation of Damages. I agree that I shall not, in any event, be entitled to any indirect, consequential, compensatory, punitive, exemplary, lost profit, lost opportunity, reputational, or other form of damages for any Claim whatsoever. I agree that I shall not be entitled to any sums of money exceeding the amount of the exam registration fee for any reason whatsoever.
  5. Waiver of Jury Trial. I hereby: (a) irrevocably waive the right to a trial by jury in any action or proceeding brought by any party in connection with this Agreement or any modification thereof; (b) attest that I have made this waiver knowingly, intentionally, and voluntarily; (c) acknowledge no reliance upon any oral or written statements made by ACBSP, other than those contained herein, either to induce this waiver of trial by jury or to modify or nullify its effect; (d) acknowledge that I have read and understood the meaning and ramifications of this waiver provision; and (e) agree to take all such actions as may be required by applicable law to allow this waiver to be enforceable.

 

To effectuate the foregoing, ACBSP is hereby granted a power of attorney to file, as attorney-in-fact for Candidate, a copy of this Agreement in any court in which any action is pending or filed.  Additionally, I stipulate to the admissibility of this Agreement for all purposes, and further stipulate to its relevance to all issues or questions related to this Agreement.  I agree that the copy of this Agreement so filed shall conclusively be deemed to constitute my unequivocal waiver of trial by jury in any proceeding arising out of or otherwise relating to this Agreement, or my certification with ACBSP.  This power of attorney is coupled with an interest and is irrevocable.  I acknowledge that I have had the opportunity to review the foregoing waiver with an attorney of my choice, the meaning and effect of the foregoing waiver are fully understood, and I make the waiver knowingly and voluntarily.

  1. I agree to indemnify and hold the ACBSP, its directors, officers, employees, attorneys, representatives, and agents (“Indemnitees”) harmless from any and all Claims, actions, suits, obligations, damages, or demands whatsoever arising out of, or in connection with:  the ACBSP certification; my professional, personal, and business activities; the ACBSP certification programs and activities; and, any actions taken by the ACBSP.
  2. Severability; Reformation. If any term or provision of this Agreement is held to be invalid, illegal, or unenforceable, such invalidity, illegality, or unenforceability shall not affect any other term or provision of this Agreement in any way. If any term is found to be unenforceable (each a “Severed Term”), the Parties shall stipulate to reform the Severed Term, modifying it by removing and adding only those words necessary to render the term enforceable and intelligible, but otherwise retaining as much of the original language and meaning as possible (resulting in the “Reformed Term”).
  3. Choice of Law; Venue. This Agreement shall be deemed to have been executed and performed in the State of Colorado and shall be governed by its laws, without regard to conflicts of law. I hereby submit to the jurisdiction of the state and federal court(s) sitting in El Paso County, Colorado, and waive any right to request a change of venue or a removal to another court.  Additionally, I stipulate to any judgment being domesticated, adopted, or otherwise rendered enforceable in any other state, including, but not limited to, states in which I, or any of my property, are located.

Addendum 1 – Waiver of Claims Pursuant to the Americans with Disabilities Act

  1. Purpose and Scope. The purpose of this Waiver is to voluntarily and knowingly waive any and all claims the undersigned may have against ACBSP (collectively, “the Parties”) under the Americans with Disabilities Act (ADA) and any related state or local laws. This Waiver applies to all past, present, and future claims related to the ADA.
  2. Definitions.

2.1 “ADA” means the Americans with Disabilities Act, as amended, and any related state or local laws.

2.2 “Disability” shall have the same meaning as defined in the ADA.

2.3 “Reasonable accommodation” shall have the same meaning as defined in the ADA.

  1. Waiver of ADA Claims.

3.1 I acknowledge and understand my rights under the ADA, including the right to request reasonable accommodations.

3.2 I voluntarily and knowingly waive any and all claims I may have against ACBSP under the ADA and any related state or local laws.

3.3 This Waiver does not apply to any claims that cannot be waived by law.

  1. Consideration. The parties acknowledge that this Waiver is supported by mutual benefits and a bargained-for exchange.
  2. Representations and Warranties. I represent and warrant that I have entered into this Waiver voluntarily and without any coercion or undue influence. I represent and warrant I have not previously commenced any type of ADA claim or cause(s) of action against ACBSP.  I represent and warrant that I have had the opportunity to review the foregoing waiver with an attorney of their choice, I understand the meaning and effect of the foregoing waiver, and I make the waiver knowingly and voluntarily.
  3. Confidentiality. The terms of this Waiver shall be kept confidential, except as required by law or as necessary to enforce the Waiver.
  4. No Admission of Liability. This Waiver shall not be construed as an admission of liability by any of the Released Parties, who expressly deny any liability or wrongdoing.
  5. Governing Law and Jurisdiction. This Waiver shall be governed by the laws of the State of Colorado and any disputes shall be resolved in the courts sitting in El Paso County, Colorado. I waive any right to request a change of venue or a removal to another court.
  6. Severability; Reformation. If any term or provision of this Agreement is held to be invalid, illegal, or unenforceable, such invalidity, illegality, or unenforceability shall not affect any other term or provision of this Agreement in any way. If any term is found to be unenforceable (each a “Severed Term”), the Parties shall stipulate to reform the Severed Term, modifying it by removing and adding only those words necessary to render the term enforceable and intelligible, but otherwise retaining as much of the original language and meaning as possible (resulting in the “Reformed Term”).
  7. Entire Agreement. This Waiver constitutes the entire agreement concerning ADA claims between the parties and supersedes any prior understandings or agreements. I am not relying on any promises or statements not made expressly in this Waiver.  This Waiver may only be modified by a written agreement signed by both Parties.
  8. Effective Date and Survival. This Waiver shall be effective as of the date of execution. This Waiver shall remain in effect in perpetuity unless terminated by mutual agreement of the parties or as otherwise provided herein.
  9. Amendments. No amendment or modification of this Waiver shall be valid unless it is in writing and signed by both parties.

Addendum 2 – WAIVER OF CIVIL RIGHTS ACT CLAIMS

  1. Waiver. In consideration of the mutual promises and covenants contained herein, I knowingly and voluntarily waive and release any and all claims, rights, demands, liabilities, actions, or causes of action arising under Title VII of the Civil Rights Act of 1964, as amended, 42 U.S.C. § 2000e et seq. (“Title VII”), which I have, or might have, against ACBSP, and its affiliates, officers, directors, employees, agents, successors, and assigns (collectively, the “Released Parties”), as of the date of this Waiver.
  2. Scope of Waiver. This Waiver applies to any and all claims, rights, demands, liabilities, actions, or causes of action arising under Title VII, including, but not limited to, claims of discrimination, harassment, or retaliation based on race, color, religion, sex, national origin, age, disability, or any other protected characteristic.
  3. Consideration. The Parties acknowledge that this Waiver is supported by mutual benefits and a bargained-for exchange.
  4. Voluntary and Informed Consent. I am stipulating to this Waiver knowingly and voluntarily, without any coercion, duress, or undue influence, and that I have had the opportunity to consult with legal counsel of my choosing before executing this Waiver.
  5. No Admission of Liability. This Waiver shall not be construed as an admission of liability by any of the Released Parties, who expressly deny any liability or wrongdoing.
  6. Governing Law and Jurisdiction. This Waiver shall be governed by and construed in accordance with the laws of the State of Colorado, without regard to its principles of conflicts of law. Any dispute arising out of or relating to this Waiver shall be subject to the exclusive jurisdiction of the courts sitting in El Paso County, Colorado. I waive any right to request a change of venue or a removal to another court.
  7. Entire Agreement. This Waiver constitutes the entire agreement between the Parties with respect to the subject matter hereof and supersedes all prior agreements, understandings, and representations, whether written or oral, relating to the subject matter of this Waiver. I am not relying on any promise or statement not expressly contained herein.
  8. Severability. If any term or provision of this Agreement is held to be invalid, illegal, or unenforceable, such invalidity, illegality, or unenforceability shall not affect any other term or provision of this Agreement in any way. If any term is found to be unenforceable (each a “Severed Term”), the Parties shall stipulate to reform the Severed Term, modifying it by removing and adding only those words necessary to render the term enforceable and intelligible, but otherwise retaining as much of the original language and meaning as possible (resulting in the “Reformed Term”).
  9. Effective Date and Survival. This Waiver shall be effective as of the date of execution. This Waiver shall remain in effect in perpetuity unless terminated by mutual agreement of the parties or as otherwise provided herein.
  10. Confidentiality. The terms of this Waiver shall be kept confidential, except as required by law or as necessary to enforce the Waiver.
  11. Counterparts. This Waiver may be executed in counterparts, each of which shall be deemed an original, and all of which together shall constitute one and the same instrument.
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