Fillable 121514 Fillable Pdf Individual Verification Re Minors Training (University of Dayton)

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121514 Fillable Pdf Individual Verification Re Minors Training (University of Dayton)

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Individual Verification of Minors Training – Page 1 of 2
INDIVIDUAL VERIFICATION REGARDING MINORS TRAINING
I, ____________________________, wish to be part of a University of Dayton
(“University”) program or event that involves minors.
I understand that, under its Minors on Campus and Working with Children Policy
(“Minors Policy”), the University requires training about the University’s Minors Policy for any
adults who wish to be authorized to work with children in the context of a University program or
event. I understand that such training contains a number of elements, including behavioral
requirements for working with child, as well as obligations to report known or suspected child
abuse. However, I underwent training on ____________ about working with children, through
(describe circumstances/program through which training received): _______________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
I have attached proof that I have taken this training as described above. The contact information
and name of the individual who can more fully describe the contents of the training and
otherwise confirm I took the training is as follows: ____________________________________
I understand that the University’s Office of Legal Affairs will need to review the training
I have taken to determine whether it satisfies the training requirements of the University’s
Minors Policy. If that office determines the training is not sufficient, then I realize I am required
to take the University’s Minors Policy training in order to be authorized to work with children as
part of a University program or event.
I further understand that one unique element in the University’s training is that, for
University events/programs involving minors,
a. any instances of known or suspected child abuse;
b. any instances of the known or suspected threat of child abuse; or
c. violations of the University’s Minors Policy;
must be reported in two ways. First, such issues must be reported to the University’s Office of
Public Safety at 937.229.2121, or, if the event/program is off campus at a facility that has an
established protocol for handling abuse incidents and reporting, then I am to report the issue
AUTHORIZED ADULT
INSERT DATE
NAME & CONTACT INFORMATION (E.G., PHONE # OR EMAIL)
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Individual Verification of Minors Training – Page 2 of 2
through their handling protocol instead. Second, such issues must be reported to the person in
charge of the program. I agree to comply with these reporting requirements. If I have any
questions regarding these reporting requirements, including but not limited to the identity of the
person in charge of the program, then I will contact the Office of Legal Affairs at 937.229.4333
or legalaffairs@udayton.edu.
The University’s reporting requirements are independent of any obligations to report that
certain individuals may have under Ohio law. I understand that if I qualify as a “mandatory
reporter” under O.R.C. § 2151.241, I am still responsible for complying with those mandatory
reporter obligations.
I understand that, if I falsify any information in this form or the attached documentation,
such falsification may result in the loss of the privilege of being involved in University programs
where minors are expected to be present, and such falsification may be considered a violation of
other University policy and therefore result in other, additional consequences.
Signed by Authorized Adult:
Signature: ________________________
Printed name: _____________________
Title: ____________________________
Date: ____________________________
Signed by an attorney within the University of Dayton’s Office of Legal Affairs:
Signature: ________________________
Printed name: _____________________
Date: ____________________________
Last updated 12-15-14
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Completed 22 July 2020

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