Oceans of Opportunity

Participant Information

Email Address

First Name

Preferred Name (if different)

Last Name

Birthdate

The pronouns I use are

Phone Number

Do we have permission to text important program information to you at this number as needed?

Yes

No

What will your grade level be in Fall 2026?

9th Grade

10th Grade

11th Grade

12th Grade

On the first day of the Oceans Residential Program, participants are welcome to bring up to five guests to join in a series of engaging activities throughout the day. While bringing guests is optional, we strongly encourage each participant to invite at least one guest to share in this special experience.

How many guests do you plan to bring?

Parent/Guardian/Supporter Contact Information

We request the information below in order to include this person in communications regarding the RISE program.

First Name

Last Name

Email Address

Phone Number

Relationship to Participant

Would you like to list this person as your emergency contact as well?

Yes, this person is my emergency contact.

No, I would like to list someone else.

Emergency Contact

Full Name

Relationship to Participant

Phone Number

Email Address

Required Documents

Release of Liability
Please follow the link to review the release of liability form. Upon review, please sign, date, and upload the form. Participants under the age of 18 must have the form signed by a legal parent or guardian.

In addition to uploading the signed Release of Liability form, please confirm your acknowledgment below.

Check below to acknowledge that you (or your parent/guardian, if under 18) acknowledge and accept the terms outlined in the Release of Liability form for participation in the RISE Program at Cal Poly Pomona?

In addition to uploading the signed Release of Liability form, please confirm your acknowledgment below.

Check below to acknowledge that you (or your parent/guardian, if under 18) acknowledge and accept the terms outlined in the Release of Liability form for participation in the RISE Program at Cal Poly Pomona?

Yes, I acknowledge and accept the terms.

Visual/Audio Image Release Form
Please follow the link to review the visual/audio image release form. Upon review, please sign, date, and upload the form. Participants under the age of 18 must have the form signed by a legal parent or guardian.

In addition to uploading the signed Visual/Audio Image Release Form, please confirm your consent below.

Do you (or your parent/guardian if under 18) give Cal Poly Pomona permission to use photographs or videos of you taken during the RISE Program for promotional purposes?

In addition to uploading the signed Visual/Audio Image Release Form, please confirm your consent below.

Do you (or your parent/guardian if under 18) give Cal Poly Pomona permission to use photographs or videos of you taken during the RISE Program for promotional purposes?

Yes, I give consent.

No, I do not give consent.

Additional Information

Current Medications
Are you currently taking any medications that we should be aware of during the program (e.g., for allergies, asthma, etc.)?

Yes

No

If yes, please list the medication(s), dosage, and any special instructions or considerations (e.g., refrigeration, timing):

Note:This information will be kept confidential and is only used to ensure your safety and well-being during the program. Our staff is not authorized to administer medications but may assist with reminders if needed.

Gender Identity (for housing accommodations)
This information helps us ensure comfortable and respectful room assignments during the RISE Program. Your response will remain confidential and only used for housing purposes.

I describe my gender as

Is there anything you'd like us to know to ensure a comfortable housing arrangement?
(Optional – This may include who you feel most comfortable rooming with, or specific requests related to your identity.)

Do you have any dietary restrictions or food allergies?

Please describe your dietary needs below so that we may notify campus dining and catering.

Do you require any accommodations to fully participate in the RISE program? If so, please explain below.

Additional Comments
Is there anything else you'd like us to know to help support your experience in the RISE program?

Guest Information for Welcome Dinner

Do any of your guests have any dietary restrictions or food allergies?

Please describe your guests' dietary needs below so that we may notify campus dining and catering.

Do any of your guests require any accommodations? If so, please explain below.

By submitting this form, I confirm that I understand and agree to fully participate in the Oceans of Opportunity Program at Cal Poly Pomona. I acknowledge the following:

Residential Participation Commitment

Oceans of Opportunity is a residential program, and I am committing to stay overnight on campus for the full duration of the program.
The program begins with check-in and move-in beginning at 9:00 AM on Sunday, July 19th and concludes with check-out beginning at 5:00 PM on Thursday, July 23rd.
I agree to fully engage in all scheduled activities, workshops, and community events as part of the Oceans of Opportunity experience.

Community Values & Conduct Agreement

I acknowledge and commit to upholding Cal Poly Pomona’s Principles of Community, which promote integrity, inclusion, respect, and social responsibility.
I understand that disruptive behavior, violation of program rules, or disregard for community principles may result in disciplinary action, including early dismissal from the program.
I acknowledge that the Oceans of Opportunity Program maintains a zero-tolerance policy for any form of harassment, discrimination, substance use, or behavior that threatens the safety or well-being of others.

By submitting this form, I confirm that I understand and agree to fully participate in the Oceans of Opportunity Program at Cal Poly Pomona. I acknowledge the following:

Residential Participation Commitment

Oceans of Opportunity is a residential program, and I am committing to stay overnight on campus for the full duration of the program.
The program begins with check-in and move-in beginning at 9:00 AM on Sunday, July 19th and concludes with check-out beginning at 5:00 PM on Thursday, July 23rd.
I agree to fully engage in all scheduled activities, workshops, and community events as part of the Oceans of Opportunity experience.

Community Values & Conduct Agreement

I acknowledge and commit to upholding Cal Poly Pomona’s Principles of Community, which promote integrity, inclusion, respect, and social responsibility.
I understand that disruptive behavior, violation of program rules, or disregard for community principles may result in disciplinary action, including early dismissal from the program.
I acknowledge that the Oceans of Opportunity Program maintains a zero-tolerance policy for any form of harassment, discrimination, substance use, or behavior that threatens the safety or well-being of others.

I acknowledge the conditions of participating in Oceans of Opportunity as outlined above (required for submission)

Oceans of Opportunity

Oceans of Opportunity Summer Residential Experience