Triton Edge 2018 Expectations

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Cameron Rodgers
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Triton Edge 2018 Expectations Always maintain 8 units during program (8 units is full time for Summer Session. 12 units is full time for Fall, Winter, and Spring quarters). Attend all AWP10 classes.

1 Triton Edge 2018 Expectations Always maintain 8 units during program (8 units is full time for Summer Session. 12 units is full time for Fall, Winter, and Spring quarters). Attend all AWP10 classes. Attend all GE (General Education) classes. Turn in all assignments by the deadlines stated in the course syllabi. Attend required individual meeting(s) with your AWP10 instructor during the term. Attend required individual meeting(s) with your AWP10 writing tutor. Attend all Cohort Meetings (TE CMs) each Wednesday evening. Attend all meetings with your Mentor Cohort Groups. Attend all mandatory on- and off-campus activities. Stay in assigned Thurgood Marshall College (TMC) housing every night of the Triton Edge Program to maximize program benefits. Abide by all program rules outlined in your signed Code of Conduct form. Ask questions! The Triton Edge staff is here to help your transition. Be respectful! Be respectful of your fellow Triton Edge participants, the Triton Edge staff, and everyone you meet. Respect is shown by timeliness, undivided attention during presentations, support of fellow students in the classroom, and more. Cell phones are to be put away during presentations and courses unless otherwise requested by the presenter or instructor. Be open! Triton Edge is about helping your transition from home to the unknowns of UC San Diego and the U.S. so be willing to try to new things, break out of your comfort zone, and meet new people. Be ambassadors! You have a five week head start on most of your first-year classmates by participating in Triton Edge. You will be familiar with campus, the academic system, and resources on campus before everyone else! You will be a helpful source of information and support to fellow classmates. Also, you may be the first person in your family to attend UCSD, to attend college in the U.S., to attend college in general, or to spend an extended period of time in the U.S.! You will be an ambassador from your home country to the U.S. and vice versa. This is a big responsibility, so be proud! Be a Triton! Be appreciative of the accomplishments that helped you get to UCSD and be excited about this new journey in your life.

2 Triton Edge Program 2018 Code of Conduct The following conduct code outlines specific expectations required for full participation in the Triton Edge Program. Please review the contract, write your initials on each line, and sign below. Attendance at all classes, activities, and meetings is mandatory for completion of the program. Absence from classes, activities, and meetings will result in an incomplete and ineligibility for a Triton Edge notation on the Co-Curricular Record (CCR). UC San Diego and Triton Edge housing regulations must be followed to maintain housing benefits. Smoking will not be permitted inside dorm rooms, classrooms, or bathrooms. Smoking is only permitted off-campus. For campus community protection and safety, the use of alcohol and drugs, on and off campus, is strictly prohibited. Students displaying disruptive behavior as a result of alcohol or drug use will be referred to a staff review committee for determination of continuing status in the Triton Edge Program. Absolutely NO overnight visitors are allowed. Visitors are NOT allowed in the residence halls during class times or meeting times. (Visitors are anyone not participating in the Triton Edge Program, including family members.) Disruptive behavior that might endanger any student or damage university property will NOT be tolerated. Quiet hours will be enforced from 11:00PM to 6:00AM every day. No visits outside the USA are permitted during Triton Edge. HARASSMENT: Physical abuse, threats of violence, or conduct (including verbal harassment) that threaten the safety or well-being of any person are prohibited. Such conduct may lead to removal from residence halls, dismissal from the Triton Edge Program, and, where appropriate, to campus disciplinary action or legal prosecution. Harassment is a form of violence and consists of written or verbal invasion or violation of an individual s rights. It may be racial, sexual or personal in nature and may be conveyed through graffiti, verbal statements, obscene telephone calls, or other means. ***Students displaying disruptive behavior as a result of not fulfilling the expectations of this conduct code will be referred to a staff review committee for determination of continuing status in the Triton Edge Program. Signature of Participant Date Signature of Parent/Guardian of minor Date

3 Medical Information Form Students will be participating in a university program, and although we anticipate that everyone will remain in good health, students may become sick or injured during this time. Therefore, it is important that program staff have access to students medical information. Participant s name: UCSD Personal ID number (PID): Birthday (month/day/year): Male Female Medical Information: Will you be taking any medication during the Triton Edge Program? Yes No If yes, please list: Are there any medical or psychological problems we should be aware of? Yes No If yes, please list: (examples: allergies, asthma, migraines, seizures, depression, ADD/ADHD, etc.) Do you have any dietary restrictions? Yes No If yes, please list: (examples: diabetes, celiac disease or gluten allergy, lactose intolerance, peanut allergy, etc.) Do you have any physical limitations? Yes No If yes, please describe limitations: ======================================================================== Medical Insurance All students participating in the Triton Edge Program will be required to have medical insurance during the summer program. The University of California Student Health Insurance Plan (UCSHIP) coverage is available for the summer or can be waived if you have international insurance. IMPORTANT: It is highly recommended that you purchase travel insurance to cover you if you are arriving prior to August 5, 2018.

4 Medical Treatment Consent Form In the event of emergency illness or any accident during the Triton Edge Program, permission is hereby granted for treatment by any physician or hospital to which the student is referred for diagnoses and/or treatment. The UC San Diego Triton Edge Program will not assume financial responsibility for any medical costs accrued during the program. It is mandatory that each Triton Edge Program participant have valid medical insurance during the program (all UC San Diego students are required to have valid medical insurance during the academic year.) CONSENT FOR MEDICAL TREATMENT 1. Medical Consent: I am voluntarily seeking health care and hereby consent to medical treatment, procedures, x-ray, laboratory tests and other health care services from Student Health and/or other contracted providers. I have the right to refuse specific treatments or procedures. I am at least 18 years of age, an emancipated minor, or the parent/legal guardian of a student under 18 years of age. (NOTE: Pursuant to Civil Codes , minors may consent to treatment for certain medical conditions.) 2. For students with University of California Student Health Insurance Plan (UCSHIP): I authorize UC San Diego Student Health Services to bill my Insurance Plan on my behalf for any outside laboratory or other expenses incurred. I accept responsibility for payment for all services not covered by UCSHIP, including any visit fees and pharmacy co pays. These charges may be paid by credit card on the day of service or charged to my university student account. 3. For students who do not have UCSHIP insurance: I accept responsibility for payment of all expenses incurred from services provided at UC San Diego Student Health Services. These charges may be paid by credit card on the day of service, or charged to my university student account. Charges include, but are not limited to, visit fees, medications, laboratory testing, x-rays, and supplies. 4. This agreement of Consent for Medical Treatment can be revoked by me at any time by written notification and is valid until revoked.

5 WAIVER OF LIABILITY, ASSUMPTION OF RISK, AND INDEMNITY AGREEMENT University of California, San Diego, Triton Edge Program Waiver: In consideration of being permitted to participate in any way in the Triton Edge Program. The program is from August 5 th -September 8 th 2018 (with the option for Extended Stay 9/9-9/21). Students attend classes Mon-Fri (8/6-9/7), participate in activities on & off campus, and participate in off-campus excursions during the week and on weekends. hereinafter called "The Activity", I, for myself, my heirs, personal representatives or assigns, do hereby release, waive, discharge, and covenant not to sue The Regents of the University of California, its officers, employees, and agents from liability from any and all claims including the negligence of The Regents of the University of California, its officers, employees and agents, resulting in personal injury, accidents or illnesses (including death), and property loss arising from, but not limited to, participation in The Activity. Assumption of Risks: Participation in The Activity carries with it certain inherent risks that cannot be eliminated regardless of the care taken to avoid injuries. The specific risks vary from one activity to another, but the risks range from 1) minor injuries such as scratches, bruises, and sprains 2) major injuries such as eye injury or loss of sight, joint or back injuries, heart attacks, and concussions to 3) catastrophic injuries including paralysis and death. I have read the previous paragraphs and I know, understand, and appreciate these and other risks that are inherent in The Activity. I hereby assert that my participation is voluntary and that I knowingly assume all such risks. Indemnification and Hold Harmless: I also agree to INDEMNIFY AND HOLD The Regents of the University of California HARMLESS from any and all claims, actions, suits, procedures, costs, expenses, damages and liabilities, including attorney s fees brought as a result of my involvement in The Activity and to reimburse them for any such expenses incurred. Severability: The undersigned further expressly agrees that the foregoing waiver and assumption of risks agreement is intended to be as broad and inclusive as is permitted by the law of the State of California and that if any portion thereof is held invalid, it is agreed that the balance shall, notwithstanding, continue in full legal force and effect. Acknowledgment of Understanding: I have read this waiver of liability, assumption of risk, and indemnity agreement, fully understand its terms, and understand that I am giving up substantial rights, including my right to sue. I acknowledge that I am signing the agreement freely and voluntarily, and intend by my signature to be a complete and unconditional release of all liability to the greatest extent allowed by law.

6 CONSENT TO AUDIO RECORD & TRANSCRIBE Permission to Audio Record: The person signing below gives permission to UC San Diego and the Triton Edge Program to record focus group discussions. At the completion of the Trion Edge Program, you will be invited to a focus group to discuss your experience in the Triton Edge Program and potential suggestions for next year s program. This focus group involves the audio recording of your discussion. Neither your name nor any other identifying information will be associated with the audio recording or the transcript. Only the research team will be able to listen to the recordings. The tapes will be transcribed and erased once the transcriptions are checked for accuracy. Transcripts of your discussion may be reproduced in whole or in part for use in the presentations or written products that result from this focus group. I understand that I will not be compensated for this use. Participant s Address CONSENT TO PHOTO/VIDEO Permission to Photograph and Videotape: The person signing below gives permission to UC San Diego and the Triton Edge Program to photograph them and take video of them. UC San Diego and Triton Edge may use the photograph and video footage as deemed appropriate to promote the program and related objectives, including using such materials on UC San Diego websites. I understand that I will not be compensated for this use. Participant s Address

Your Name Age Please Print Organization UCSD OUTBACK ADVENTURES MEDICAL QUESTIONNAIRE (For use with programs using the UCSD Odyssey Course or Leap of Faith) Please read: This form is intended to

7 Your Name Age Please Print Organization UCSD OUTBACK ADVENTURES MEDICAL QUESTIONNAIRE (For use with programs using the UCSD Odyssey Course or Leap of Faith) Please read: This form is intended to remind staff and participants of the seriousness of attempting adventure activities with a pre-existing medical condition or personal safety concern. Questions Response 1. Do you have any pre-existing medical conditions? Yes No If yes, please explain: 2. Are you taking any current prescription or non-prescription medication? Yes No If yes, what are they and what are they for? 3. Do you have any heart conditions? Yes No If yes, please explain: 4. Do you have high blood pressure? Yes No 5. Do you have any allergies (food, bees, insects, and medicines)? Yes No If yes, please explain: 6. Do you foresee any problems participating in the upcoming Challenge Course activity due to a lack of physical exercise back home? Yes No If yes, please explain: 7. Do you feel any pressure or coercion from employer or others to participate? Yes No 8. Do you have a disability (physical, intellectual, emotional)? Yes No If yes, please indicate the functional implications and any concerns about participation related to the disability. 9. Describe your current level of physical activity: 10. Do you weigh over 75 pounds? Yes No Zipline Weight Restrictions: The zipline hydraulic systems have a weight range of 75 to 275 pounds. Please speak with your Lead Facilitator if your weight falls outside of this range to discuss alternative options for exiting the course. Your weight does not impact your accessibility to the rest of the Odyssey High Course. In case of emergency, contact: Medical Insurance (company and policy number): Phone: Participant (or parent/guardian if participant is under 18 years of age) - please read and sign I have honestly disclosed to the staff any medical, psychological or personal information relating to my health and personal safety. I will remember that a Challenge by Choice atmosphere exists at all times and I should not feel pressured to participate. Participant Signature Date Signature of Parent/Guardian of Minor Date

8 Participant's name: Please Print UNIVERSITY OF CALIFORNIA, Waiver of Liability, Assumption of Risk, and Indemnity Agreement Waiver: In consideration of being permitted to participate in any way in hereinafter called "The Activity", I, for myself, my heirs, personal representatives or assigns, do hereby release, waive, discharge, and covenant not to sue The Regents of the University of California, its officers, employees, and agents from liability from any and all claims including the negligence of The Regents of the University of California, its officers, employees and agents, resulting in personal injury, accidents or illnesses (including death), and property loss arising from, but not limited to, participation in The Activity. Signature of Parent/Guardian of Minor Date Signature of Participant Date Assumption of Risks: Participation in The Activity carries with it certain inherent risks that cannot be eliminated regardless of the care taken to avoid injuries. The specific risks vary from one activity to another, but the risks range from 1) minor injuries such as scratches, bruises, and sprains 2) major injuries such as eye injury or loss of sight, joint or back injuries, heart attacks, and concussions to 3) catastrophic injuries including paralysis and death. I have read the previous paragraphs and I know, understand, and appreciate these and other risks that are inherent in The Activity. I hereby assert that my participation is voluntary and that I knowingly assume all such risks. Indemnification and Hold Harmless: I also agree to INDEMNIFY AND HOLD The Regents of the University of California HARMLESS from any and all claims, actions, suits, procedures, costs, expenses, damages and liabilities, including attorney s fees brought as a result of my involvement in The Activity and to reimburse them for any such expenses incurred. Severability: The undersigned further expressly agrees that the foregoing waiver and assumption of risks agreement is intended to be as broad and inclusive as is permitted by the law of the State of California and that if any portion thereof is held invalid, it is agreed that the balance shall, notwithstanding, continue in full legal force and effect. Acknowledgment of Understanding: I have read this waiver of liability, assumption of risk, and indemnity agreement, fully understand its terms, and understand that I am giving up substantial rights, including my right to sue. I acknowledge that I am signing the agreement freely and voluntarily, and intend by my signature to be a complete and unconditional release of all liability to the greatest extent allowed by law. Signature of Parent/Guardian of Minor Date Signature of Participant Date Vol Waiver 7/01

Math + Leadership Camp Rancho Minerva Middle School July 11-22, Registration Form

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