By signing this application, I attest that all the information on this application is true and accurate to the best of my knowledge.

Moreover, I authorize the release of the student’s official academic records to the Grant Funded Student Programs (GFSP) at Palomar College, understanding that the information in these records will be used only to assess the student’s need for TRIO program services, discern the student’s educational progress, evaluate the effectiveness of TRIO program activities, and fulfill TRIO program-reporting requirements.

Additionally, I authorize GFSP to use the student’s name, statements and likeness, without charge, for promotional purposes in GFSP publications, advertising, video, and other formats.

Finally, my child and I agree to indemnify, save, and hold harmless and release and forever discharge Palomar College and their employees and agents by reason of acts, illness, injury or other consequences arising out of or resulting directly or indirectly from my child’s participation in the aforementioned program, or any time subsequent thereto.

I hereby give consent to Palomar College and their employees and agents to render medical treatment and assistance to my child if the rendering of such treatment should become necessary or desirable during the course of the program.