Permission slips will be accepted until: May 20, 2022 (or until all spots are filled, which may be sooner).  Spots will be filled on a first-come first-served basis, so we will notify you of whether or not you have a spot in the camp.

Please note: a copy of your grades and a $10 deposit will be required for your registration to be complete and your spot to be reserved.

Please read, complete, and sign all sections below.  

First Name *

Last Name *

Student Cell Phone

Email *

First Name *

Last Name *

Parent/Guardian Phone Number *

Email *

Full Name *

Relationship to Student *

Phone Number *

Full Name *

Relationship to Student *

Phone Number *

Is the student being treated by a physician for an injury, illness, or other medical condition that could impact participation in a field trip or event? *
- Select Option Yes No

Please list any medical condition(s) we should be aware of, that could impact your child's participation in trips and events. (If not applicable, enter "NA.") *

If there are any steps that need to be taken to accommodate the student's medical condition(s), please list them here. (If not applicable, enter "NA.") *

Please list any medication the student will need to have with them during trips and events. (If not applicable, enter "NA.") *

If you need to have a dose of your medication during the trip, please bring it with you to self-administer in the presence of TRIO Talent Search staff.

Please list any food allergies or dietary restrictions the student has. (If not applicable, enter "NA.") *

Please read the following statements and sign below to give your consent.

As the parent, legal guardian, or foster parent of the minor child listed above, I hereby certify that the above information is the most up-to-date and correct to the best of my knowledge that I agree to the following as a condition of my child’s participation in the GVSU program or visit and related activities.

I give my permission to GVSU, St. Mary’s Hospital, Spectrum Health Care System, or any other health care providers close to the field trip site to provide, seek, obtain, or approve any routine, necessary, or emergency health care during the minor child’s involvement in the GVSU programs.  I understand that this authorization is given in advance of any specific diagnosis, or treatment or medical care being required and is to serve as specific consent to any and all such diagnosis, treatment or hospital care which  may be deemed advisable.  I understand my rights under the Health Insurance Portability and Accountability Acts (HIPPA) and authorize GVSU to release information as necessary for managing program health care.

I acknowledge that participation in the visit and related activities involves assumed and inherent risk of personal injury.  I assume such risk on behalf of the minor child and give my permission to the minor child to participate in all program activities.  I release and agree to hold harmless GVSU, its Board of Trustees, students, and employees from all claims, actions, damages and liabilities for personal injury or damage relating to or arising out of any activity except where the injury or damage is caused by the gross negligence of the University’s employees.  I understand that the minor child will be subject to the rules and regulations of the GVSU visit and related activity.  I understand that any person who repeatedly disobeys University policies or procedures, or those of the TRIO Talent Search program, will be immediately expelled from the program. 

Click and drag with your mouse to sign.

We are not allowed to transport any students to or from their homes. A parent or guardian will be expected to provide transportation for their son/daughter.

Drop-off and pick-up details for this camp will be announced at a later date, as we are still in the process of determining whether the drop-off location will be the Allendale or Grand Rapids campus of GVSU.  We will notify parents and students of further details via email and Remind, if the student is signed up for our Remind.

If a parent/guardian does not pick their son/daughter up at the end of the camp, and the student doesn’t have another way to get home, we will attempt to contact you via the phone number(s) you provided.  If we are not able to reach you, we will try to reach the emergency contacts you list above.  If we exhaust all other options and still cannot reach you, as a last resort we will contact GVSU Campus Safety Department and the police will assist us with trying to locate you.  

I understand and agree to the transportation policy above. *
- Select Option Yes No

All advising services are provided free of charge. However, optional field trips and activities will sometimes require students to pay a portion of the cost of food, transportation, or activities.

This camp requires a $10 registration fee due to the high cost of overnight lodging, meals, and supervision.

Please note, your registration will not be complete until we receive your $10 payment. 

After you complete this permission form, you will have the option to pay online with a credit card.  If you are not paying by credit card, select the option to pay by check.

You can contact your TRIO Talent Search Advisor or the TRIO ETS office to arrange check or cash payment.  You can reach our office coordinator at (616) 331-7111 or vaasle@gvsu.edu.

All students will be required to wear a T-shirt for identification and safety purposes.  After the camp, the shirt will be yours to keep.  Shirts are unisex sizing.  If you are unsure of your size, please guess a size up, as we only order the size you indicate and cannot exchange it for another size the day of the camp.  

Please select your T-shirt size: *
- Select Option Small Medium Large Extra-Large 2X-Large

This camp is offered as a reward for students who are striving for academic excellence. Students with an A or B average will be given first priority, though students with lower grades may be accepted if space is available and if they have a high level of participation in TRIO Talent Search. 

All students must submit a copy of their grades for the current semester.  If you are unable to upload your grades to this form, you can give them to your TRIO Advisor at school, email them to our office coordinator at vaasle@gvsu.edu, or mail or bring them to the TRIO office at:

Grand Valley State University
TRIO Educational Talent Search
510 Fulton Street West
Grand Rapids, MI 49504

Upload a copy of your grades here.
Please upload a file with the extension .csv, .xls, .doc, .pdf, .rtf, .pages, .docx, .odt, .xlsx, .pub, .bmp, .gif, .jpeg, .jpg, .png, .tiff, or .txt with a maximum size of 2 MB (2048 KB)

Please read each of these statements and then sign below to give your consent.

I hereby grant permission for my child/dependent, the above named student, to participate in a visit to the Allendale campus of Grand Valley State University.

I understand that the overnight accommodation is at one of the student dorms on the Allendale campus, where the student will have one or more roommates assigned to their room.  TRIO ETS staff will also be staying in the dorms overnight and will make sure students do not exit their assigned rooms during the night after curfew and lights out.  

I understand that students will be participating in recreational games and sports. 

I, as well as my child/dependent, understand that all students participating in this event will be responsible in conduct to adult chaperones at all times.

I will not hold any school district, Grand Valley State University, the TRIO Educational Talent Search Program, or their employees, volunteers or agents responsible for any injury to my child that occurs during any trip taken in good faith.  

I understand that GVSU is not responsible for lost or stolen property.

I have read this entire minor child program release form. I fully understand it and I agree to be legally bound by it.

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Please read the following statements.  If you agree to these terms (which are optional and not required for participation) please sign below.

I, the Parent/Guardian of the above named student, hereby authorize GVSU TRIO Educational Talent Search to:

1. Take photographs, video, and/or electronic images of my child during the event or trip and use the student’s name in connection with these images/recordings.
2. Use, reproduce, exhibit or distribute in any medium these recordings for any purpose that the University, and those acting pursuant to its authority, deem appropriate, including promotional or advertising efforts.

I give permission to GVSU, to use, without charge and without reservation, my child’s likeness in any medium and for any lawful purpose, including promoting the University, its programs and services.  I waive any rights of action I may have and release GVSU and its licensees from any and all claims I may have arising from my child’s likeness, including the rights to sue for defamation or violation of my rights of privacy and publicity.

Click and drag with your mouse to sign.

If you do not want your child's photo taken, please contact our office at (616) 331-7110 or vaasle@gvsu.edu.

Refusal to sign the photo & video release portion of the permission slip does not impact the student's right to participate.