Upon request, the Regional Math/Science Center may secure copies of any and all subsequent information and materials
relative to the applicant's academic performance, including both high school and college/university transcripts and financial aid
information. I (we) realize that the requested data is required by the US Department of Education of all current and former
participants. I (we) understand that this consent form is good for 12 years.
I (we) understand that a student participating in the Regional Math/Science Center will be engaged in certain educational and
recreational activities, including but not limited to camping, hiking, canoeing, and initiative activities that come with the risk of
physical injury. I (we) understand also that various field trips to off-campus locations may be taken under the supervision of the
Regional Math/Science Center.
In consideration of participating in the Regional Math/Science Center, I (we) understand that Frostburg State University (the
"University") shall, in no way, be deemed responsible for the operation, safety, and management of any means of transportation,
public or private, or off-campus facilities used while participating in the Regional Math/Science Center.
I (we) do myself, my heirs,
and personal representatives, hereby defend, hold harmless, indemnify, and release the State of Maryland, the University, the
Regional Math/Science Center, and all its officers, agents, and employees from and against all claims, demands, and actions, or
causes of action, on account of damage to personal property, personal injury, or death which may result from my (our) participation
in the Regional Math/Science Center
I (we) understand that all participants must have a physical examination before participating in the Regional Math/Science
Center. I (we) understand that I (we) am solely responsible for determining whether the participant has any physical or mental
limitations preventing him or her from participating in the Regional Math/Science Center. I (we) further understand that the
University has no actual or constructive notice of any such limitation, and hereby release the State of Maryland, the University,
and its officers, agents, and employees, from any liability arising from any injuries from such limitation.
I (we) give consent for the participant to receive routine and/or emergency medical services (if needed) for the participant's
entire enrollment period in the Regional Math/Science Center.
I (we) understand that pictures of participants are routinely used in promotional and program materials such as newsletters,
videos, web pages, calendars, etc.
I (we) will indicate in writing if we do NOT want our child's picture used in such materials.
I (we) understand that that the RMSC staff will be working with my student throughout the academic year and I (we) give
permission for the staff to meet with my student at his/her home school.
In signing this application, I (we) understand that my (our) son/daughter/ward is applying for the Regional Math/ Science Center, a year-round academic program which includes a multi-week summer residential program at Frostburg State University and an academic year component, and that my (our) child/ward is expected to participate in both components.
I(we) will supply income verification information. I (we) verify that I (we) have reviewed this application and the information given is correct to the best of my (our) knowledge. I (we) understand that information supplied in this application will be confidential and is required by the United States Department of Education, the funding source.