• Adirondack Community College-UB 2-Consent Form

  • TRIO UPWARD BOUND AT SUNY ADIRONDACK

    640 BAY ROAD | QUEENSBURY, NY 12804

    518-743-2299 | UPWARDBOUND@SUNYACC.EDU

  • Student Release Form

  • Activity and Transportation Release: 

    I hereby give permission for my child to participate in all Upward Bound activities, trips, and events and for the Upward Bound program to arrange transportation to and from Upward Bound sponsored events, in college vehicles, or in other vehicles driven by competent adults designated by the Upward Bound program. In addition, I give permission for persons affiliated with the Upward Bound program to visit my child at their school, either in person or virtually via an online video conference application.

  • Date
     - -

  • Media Release:

    I hereby grant SUNY Adirondack specific permission and the unrestricted right to photograph and/or make a video and/or sound recording of my student and to use and publish images and recordings of them in any manner or medium; to alter the same without restriction; to copyright the same; and to distribute and/or display the same.

    I hereby waive the right that I may have to inspect or approve the finished product or products or the advertising copy or print matter that may be used in connection therein or the use to which it may be applied.

    I hereby release and discharge SUNY Adirondack, and all persons acting with the College’s permission or authority, from any and all claims or liability by virtue of distortion, blurring, alteration, or optical illusion and/or use in composite or digital l form whether the same is intentional, or otherwise, from any claims or liability for libel or invasion of privacy, and for any other claims or liability that may occur. This agreement is indefinite unless specified below.

  • Date
     - -

  • Physical Activity Release

    I hereby give permission for my student to participate in physical activities during the academic and summer program. I am aware that participation in sports and other physical activities involves some risk of injury and I have had the opportunity to discuss these risks with program administrators.

  • Date
     - -
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