Student Registration

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Registration Type


Registration Code

Note: The Registration Code is cAsE seNsiTiVe and must be all on one line

Student Registration

Personal Details

Name

Date of Birth

Contact Details

Email Addresses

Email Address for Registration Confirmation

Recruiter Information Sessions

Graduate programs and institutions will be hosting information sessions throughout Fall 2021. Emails will be sent once each day or week with upcoming information sessions. How often would you like to receive these emails?

Student Registration: Demographics

Gender

Ethnicity

Student Registration: Demographics

African American or Black Ancestry

Student Registration: Demographics

Asian Ancestry

Student Registration: Demographics

Hispanic or Latino Ancestry

Student Registration: Demographics

Native American or Alaska Native Ancestry

Student Registration: Demographics

Native Hawaiian or other Pacific Islander Ancestry

Student Registration: Demographics

White Ancestry

Student Registration: Academics

Academic Details

Institution

Academics

Student Registration: Academics

Academic Support and Graduate Preparation Programs

Please indicate your program affiliations

Student Registration: Academics

Graduate School Plans

Student Registration: Special Requests

ADA Accommodations Request

Student Registration: Final Steps

Terms and Conditions

Waiver of Liability, Assumption of Risk, and Indemnity Agreement

Waiver: In consideration of being permitted to participate in any way in the California Forum for Diversity in Graduate Education (hereinafter called "The Forum"), 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, The Trustees of The California State University, , or its employees, officers, directors, volunteers, and agents from liability from any and all claims including the negligence of The Regents of the University of California, The Trustees of The California State University, , or its employees, officers, directors, volunteers, and agents resulting in personal injury, accidents or illnesses (including death), and property loss arising from, but not limited to, participation in The Forum.

Assumption of Risks: Participation in The Forum 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 Forum. 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, The Trustees of The California State University, , or its employees, officers, directors, volunteers, and agents 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 Forum 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.

Video, Audio, and Image Release

I grant permission to The Forum and its employees, officers, directors, volunteers, and agents, to take and use visual/audio images of me. Visual/audio images are any type of recording, including but not limited to photographs, digital images, drawings, renderings, voices, sounds, video recordings, audio clips or accompanying written descriptions. The Forum will not materially alter the original images. I agree that the Forum and , own the images and all rights related to them. The images may be used in any manner or media without notifying me, such as university-sponsored web sites, publications, promotions, broadcasts, advertisements, posters and theater slides, as well as for non-university uses. I waive any right to inspect or approve the finished images or any printed or electronic matter that may be used with them, or to be compensated for them.

I release The Forum and its employees, officers, directors, volunteers, and agents, including any firm authorized to publish and/or distribute a finished product containing the images, from any claims, damages or liability which I may ever have in connection with the taking of use of the images or printed material used with the images.

Signature of Participant

I agree to allow the Forum Coordinators to share any or all of the information on this form with any of the educational institutions participating in The Forum.

Parent/Guardian Signature for Minor

I agree to allow the Forum Coordinators to share any or all of the information on this form with any of the educational institutions participating in The Forum.

Summary

Please review your registration information below. If you need to update any information, click the 'Edit' button in the respective section.

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