College Exploration Day

Participant Type

Prospective Student

Parent / Guardian / Supporter

Newly Admitted Student

Other Community Member (Non-Student)

Please select your affiliation.

First Name

Last Name

Email

Phone Number

Affiliated School

What organization are you representing?

Student Participant Information

Parents/Guardians/Supporters, please fill out the information below using your student's information.
There is a section at the end of the form for parent/guardian/supporter information.

First Name

Last Name

Email Address

Birthdate

Phone Number

Bronco ID Number

Gender Identity
This information is used for data and reporting purposes only.

Will a parent or guardian be attending with you?

Yes

No

How many guests do you plan to bring?

*All attendees under the age of 18 must be accompanied by an adult.

Academic Information

Current or Last Attended School Name

Supporter Information

Please note that the information below is used to include this person in College Explorer Days communications. Participants do not need to register each guest.

Relationship to Student:

Supporter First Name

Supporter Last Name

Supporter Email Address

Supporter Phone Number

Emergency Contact Information

In case of an emergency during the program, the University may contact the person listed below (must be a parent or legal guardian if you are a minor).

First Name (Person to contact in an emergency):

Last Name (Person to contact in an emergency):

Relationship to student (e.g., parent, spouse, aunt, sister, etc.):

Cell Phone Number (e.g. (555) 555-5555):

Alternate Phone Number (if available):

Consent and Liability

Media Release

I give permission for the participant(s) to have photographs or videos taken. I also grant full rights to use the images resulting from the photography/video filming/, and any reproductions or adaptations of the images for fundraising, publicity, or other purposes. This might include (but is not limited to), the right to use them in printed and online publicity, social media, press releases and funding applications. Please check the box below if you have read/consent to the above statement.

Release of Liability
Please follow the link to read the RELEASE OF LIABILITY

I agree to the conditions stated in the CPP Release of Liability Form.

Please type your full legal name (in lieu of a signature).

If Participant is under 18 years of age, this must be signed by the parent/legal guardian of the Participant.

All attendees under the age of 18 must be accompanied by a parent or guardian. If you have any questions, please email caminos@cpp.edu. Thank you!