TRiO Upward Bound Program

Pima Community College  Desert Vista Campus

5901 South Calle Santa Cruz
Tucson, Arizona 85709-6000
Telephone: (520) 206-5073  Fax: (520) 206-5206  Cell Phone: (520) 269-9888 or (520) 269-9882

PARENT PERMISSION FORM FOR TRIO UPWARD BOUND – SPONSORED ACTIVITIES

Dear Parent or Legal Guardian:

Your son/daughter is eligible to participate in an TRiO Upward Bound Program activity requiring transportation to a
location away from their school or Pima Community College- Desert Vista campus building. Activities will take place
under the guidance and supervision of employees of the TRiO Upward Bound Program at Pima Community College.

Grant Objectives: Objectives #1, 2, 3, 4, 5, 6

Destination: Mystery Escape Room- Tucson Mall- 4500 N. Oracle Rd.

Designated Supervisor of Activities: Carlos Romero, Program Coordinator

Date and Time(s): Meet at PCC Desert Vista Campus at 10:30am on Saturday, December 9, 2023, event will be from
1:00pm until 2:30pm, we will eat lunch before the event. Our expected RETURN TIME to Pima: 3:00pm

Method of Transportation: 12-passenger vans (2)

If you would like your child to participate in this event, please complete, sign, and return the following statement of
consent. As parent or legal guardian, you remain fully responsible for any legal liability which may result from any
personal actions taken by the named student.

I hereby consent to participation by my child, ____________________________________, in the event described above.

I understand that this event is taking place away from the school or Pima Community College grounds and that my child
will be under the supervision of the designated Upward Bound employees on the activity date. I further consent to the
conditions stated above on participation in this event, including the method of transportation. In consideration of my child
being allowed to participate in this fieldtrip, I agree on behalf of myself and my child, to release Pima County Community
College District, its employees, volunteers and agents, and any/all affiliated organizations, their employees, agents and
representatives (collectively "Releases") from any and all claims, which may be asserted by me or my child, or on behalf
of my child, arising from or relating to my child’s participation in this TRiO Upward Bound Program activity. In the event
this release on behalf of myself and/or my child is held to be invalid or unenforceable, I hereby agree to indemnify and
hold harmless Releases from any and all claims which may be asserted by me or my child, or on behalf of my child,
arising from or relating to my child’s participation in the field trip. This release of indemnification does not apply to
claims for intentional misconduct or gross negligence.

Parent/Guardian Name (Please Print) __________________________________________________________________

Parent/Guardian Signature _______________________________________________ Date ______________________

_____________________________________________
******PLEASE TEAR OFF THIS PORTION OF THE PERMISSION FORM FOR YOUR KEEPING******
Event Title: Mystery Escape Room @Tucson Mall Event Date: Saturday, December 9, 2023
Time to meet at Pima: 10:30am Event time: 1:00pm – 2:30pm
Return to Pima time: 3:00pm