2024 Upward Bound Summer Program Registration
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    • Weekly Schedule (tentative) 
    • DEADLINE TO REGISTER IS APRIL 30 AT 11:59PM

      DATES: M-F June 24 - August 2, 2024
      TIMES:
      Monday through Thursday 8:00am - 3:00pm; varies on Fridays 

      THEME: We all have a story to tell, whether your family migrated here, or your family has been here for generations. Join Upward Bound Legacy Scholars for our 6-week summer program to share your story and learn the interrelatedness of your story with others, and how we are all connected as human beings in this world through intergenerational learning. There will be academic courses Monday through Thursday (math, lab science, English, and Spanish) alongside elective courses and a capstone class, and Fridays we will have weekly field trips.

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    • A full, finalized schedule will be sent several weeks prior to the start of the summer program. Please contact Claudia at (253) 888 2078 or ckrumpach@pierce.ctc.edu if you have any questions!

    • Community Guidelines (PLEASE READ) 
    • Before continuing to registration, please read the community guidelines below.

    • The rules and regulations below are to be followed to ensure everyone has a safe and fun experience during the program and on our field trips. During orientation on June 24th, we will also be collectively creating community guidelines for one another. Please read the rules below carefully. 

      • Drugs, alcohol, vapes, and e-cigarettes are absolutely prohibited. Students that are found with or using any of these items will be sent home and face disciplinary action. Consumption/possession of these items is also prohibited and will result in students being sent home at the parent/guardian's expense.  
      • Students with prescription medicine must notify Pierce Upward Bound staff prior to departure.  
      • Students are required to stay with the group at all times.  
      • Students will be representing Clover Park High School and Pierce College on campus and at field trips. We expect our students to behave in a mature and responsible manner.
      • Students are expected to maximize this opportunity by fully participating in activities, asking questions and engaging.

      Dress Code to Make a Good Impression 
      Please adhere to CPHS school dress code and remember, we want to present ourselves in the best possible manner!

      Anyone that violates the community rules and regulations will be removed from the summer program and must return home at the parent/guardian's expense. They will also risk no longer being able to attend field trips for the remainder of the year and potentially undergoing a re-engagement assessment prior to joining us on field trips next year. 

  • Summer Program Registration

    Please fill out the information below alongside your parent or guardian!
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  • Format: (000) 000-0000.
    • Terms of Agreement & Release of Liability 
    • TERMS OF AGREEMENT

      I hereby agree to fulfill all the terms listed below as a participant in the above event:

      1. I understand that as Pierce College has in part, or in whole, assisted in supporting this activity, that I am representing Pierce College, and I agree to conduct myself in accordance with the Student Rights and Responsibilities policy. Failure to conduct myself in a manner consistent with this policy may result in my being subject to disciplinary action as provided for under Disciplinary Action (WAC 132K-126).

      2. I understand that I am participating in the Pierce College Legacy Scholars and Upward Bound at my own risk. I agree voluntarily and without reservation to indemnify and hold harmless Pierce College and its officers, employees, and agents from any and all liability, loss, damages, costs, or expenses (including attorney's fees) which do not arise out of the negligent act or omission of an officer, employee, and/or agent of the institution while acting within the scope of their employment or agency, as a result of my participation in the program, including any physical injury or loss thereto.

      3. I also understand that I am participating in this event as a representative of Pierce College As such a representative, I understand that any actions I take at the event will positively or negatively affect opinions of others about Pierce College Legacy Scholars.

      4. I further understand that consuming alcohol or using drugs of any kind on any Pierce College owned, leased, rented, or operated vehicle or during any college-sponsored activity, including this program, is prohibited.

      5. I agree not to leave the program site at any time unless a Pierce College Official has given specific prior approval.

      6. I agree to reimburse Pierce College for all fees and associated travel, lodging, and meal costs if I fail to comply with the terms listed above and am asked to leave an event associated with the Pierce College Legacy Scholars.

      7. In case of emergency, I request that the college contact the person listed below. If family or friends cannot be reached by reasonable methods, I hereby grant permission for agents of Pierce College District 11 to administer, or cause to be administered, emergency measures to sustain life and stabilize my condition while awaiting medical assistance personnel, or my designated family contact person.

      8. I certify that I have no physical, medical, mental or emotional impairments, conditions, or concerns that might jeopardize or affect my safety, or the safety of others, related to my participation in this activity.

      9. I understand that the college nor its agents or employees serve as my guardian or insurer of my safety and understand that the college does not provide any special insurance for my protection.

      10. In consideration for being allowed to participate in events and activities organized or facilitated by Pierce College, I voluntarily agree to assume all risks involved in using the programs, services, facilities, vehicles, and equipment of Pierce College. I understand that direct supervision by Pierce College staff may not be provided and by using the programs, services, vehicles, and facilities of Pierce College, I expose myself to risk of injuries including, but not limited to: temporary or permanent muscle soreness, sprains, strains, cuts, abrasions, bruises, ligament and/or cartilage damage, head, neck or spinal injuries, loss of use of arms and/or legs.

      RELEASE OF LIABILITY

      I certify that I am of lawful age and competent to sign this statement of Informed Acknowledgement and Consent. I hereby
      voluntarily sign this document and knowingly assume the risks associated with this activity. I further understand that behavior inconsistent with the terms herein may result in student discipline per the Student Code of Conduct.

      In consideration of the right to participate in the Pierce College Legacy Scholars Program and the services arranged for me by Pierce College, I have and do hereby assume all the above-mentioned risks and any other risks reasonably arising from my participation in the Pierce College Legacy Scholars/ Upward Bound Program and I agree voluntarily and without reservation to indemnify and hold harmless the state of Washington, the trustees of Pierce College and the officers, employees, and agents of Pierce College from any and all liability, loss, damages, costs, or expenses (including attorney's fees) which do not arise out of the negligent act or omission of an officer, employee, and/or agent of the institution while acting within the scope of their employment or agency, as a result of my participation in the program, including any travel incident thereto. The terms hereof shall serve as a release and assumption of risk for my heirs, administrators, and for all members of my family, including any minors accompanying me. (Parent or legal guardian should sign for all persons under eighteen (18) years of age.)

      If any part or portion of this Assumption of Risk and Release of Liability is determined to be invalid or unenforceable, the remaining parts or portions shall be enforceable. I have carefully read this Assumption of Risk and Release of Liability and fully understand its contents.

    • Emergency Contact & Parent / Guardian Signature 
    • Parent / Guardian Contact Information

    • Format: (000) 000-0000.
    • Emergency Contact

      If, in the event of a medical or other emergency, I/we am/are (the parent/guardian) unable to be reached by telephone, I/we authorize the activity supervisor(s) to attempt to contact me through the emergency contacts listed below.
    • I, the undersigned, am aware and assume responsibility for my/the student's actions in participating in the following activity:

      Summer Program: June 24 - August 2, 2024, M-F
      Location: M-Th at Pierce College Fort Steilacoom, Fridays at various locations (field trips)
      Details: Students must arrange their own transportation to arrive promptly at 8:00am for breakfast! On Fridays, we will have field trips. Students will meet at Pierce College Fort Steilacoom and we will arrange a bus to transport us to the field trip location. 

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