I hereby give the TRIO-Educational Talent Search (ETS) At California State University, Dominguez Hills (CSUDH) program staff permission to have access to report cards, high school transcripts, college/university transcripts and enrollment data, standardized test results, and other pertinent academic information and student records. I understand that this permission will be in effect throughout my child’s participation in the ETS program and six years after their high school graduation. I understand that ETS is not a part of the regular and ongoing programs of the school or the Los Angeles Unified School District (LAUSD). This service is made available at the school site for my convenience to obtain services for my child. To facilitate provision of program services, I grant consent for my child to be occasionally called out of class for advising by ETS staff. Finally, I certify that all information provided in this application is accurate and true to the best of my knowledge.
In the event that my child is offered and accepts an invitation to participate in the CSUDH TRIO-Educational Talent Search program:
- I affirm that my child is in good health and able to participate in ETS activities. I voluntarily assume the risk of any possible injury/illness or property damage associated with their participation in ETS activities: in person or virtually. If my child needs emergency medical treatment and their emergency contact cannot be reached, I consent to any medical treatment deemed advisable by any licensed physician and agree to be financially responsible for any costs incurred as a result of such treatment. I understand that CSUDH does not provide health or accident insurance for participants. I have been advised to provide my own medical and hospital insurance.
- I grant CSUDH TRIO-ETS permission and the right to photograph or record my child and to place such media in university publications and/or to make them available to outside media for educational use only. These will be taken during ETS activities, field trips, and other events. I understand and acknowledge that neither I nor my child will receive any monetary compensation for the use of their likeness; have the opportunity to inspect or approve any photograph prior to its use or release; or have any copyright interests in any photograph. The University agrees that if it selects a photograph of my child, that photograph will not be used for any purpose other than to promote the University or ETS. I understand that the determination of what is “promotional” rests solely with the University.
- In consideration of my child’s participation in ETS, on behalf of them, myself, all heirs and assigns, I release and hold harmless the State of California, the California State University Trustees, California State University, Dominguez Hills, the California State University, Dominguez Hills-Foundation, and their respective officers, agents, volunteers and employees from any and all claims, damages, losses, causes of action and demands and all costs and expenses incurred in connection therewith resulting from or in any manner arising out of or in connection with my child’s participation in ETS.
- I agree to indemnify and hold harmless the State of California, the California State University Trustees, California State University, Dominguez Hills and their respective officers, agents, volunteers and employees from liability and responsibility for any claims or demands arising out of the acts or omissions of my child during their participation in ETS.