Parental Consent Form

I, the undersigned parent/guardian, hereby grant permission for 
name of student: *

to participate in The University of New Mexico Upward Bound Program. I understand participation to mean involvement in any official function and/or activity sponsored by the Upward Bound Program, which includes sponsored workshops, field trips, tutoring and/or advising session, and the Upward Bound Summer Program. I understand the Upward Bound Administration may share information with the Public School Administration for the benefit of my child. 

  I understand that going on field trips and other off campus excursion poses some risk related to travel and my child being in possibly unfamiliar environments. I accept these risks and in consideration of my child being permitted to participate in the Upward Bound Program, I agree that any claim I or my child may have now against UNM, its officers, employees or agents, arising out of my child's participation in Upward Bound, shall be governed by the law of the State of New Mexico Tort Act which limits lawsuits against UNM and its employees. 

  In addition, in case of an accident or illness requiring emergency medical care, I authorize the staff of the Upward Bound Program to take any and all necessary steps to obtain and to consent for the necessary and proper medical treatment and care of my son/daughter. I understand that I will be notified of an accident or illness as soon as possible. 

  I give consent for this authorization to remain in effect as long as my son/daughter is an active participant in the Upward Bound Program. 

Parent/Guardian Signature: *
Signature Type: SMS    Start Over
After validation, the cell phone number will become part of the electronic signature.
Cell Phone Number:

Date: *