division of community learning

Youth Protection Registration

Each form entry should be for one event/program. If you have several of the same program running each year, we still need them separated by individual entries. Program offerings by/through BW that interact with minors (either in-person or online) must align with the policies, regulations and standards set forth by the Division of Community Learning. We understand that there may be information you do not have yet or has not been confirmed. Please complete what you can at this time and ‘save progress’ until that information is known – at which time you can make the appropriate updates. For questions contact Kirsten Bramley at 440-826-2499 or kbramley@bw.edu.

Contact Information

Full Name(Required)

First Last

Email(Required)

Phone(Required)

Department(Required)

Program Details

*Official Name of Program(Required)

*Begin Date of Program(Required)

*End Date of Program(Required)

*Daily Start Time(Required)

For residential programs, these times should reflect "formal programming", knowing that that time overnight is understood.

*Daily End Time(Required)

For residential programs, these times should reflect "formal programming", knowing that that time overnight is understood.

Primary Location(Required)

Primary Room(s)(Required)

If multiple, put comma between each room you are using.

Name of off-campus location(Required)

Enter N/A if none

Address of off-campus location(Required)

Enter N/A if none

Street Address City State / Province / Region ZIP / Postal Code Country

*Provide the program description that explains what activities minors will be doing in the program:(Required)

*What grades are eligible for this program?(Required)

Are you working with any campus services to provide this program?(Required)

Dining/Catering Services

Residence Life

Conference and Event Services

Buildings and Grounds/Aramark

Information Technology (IT)

Safety and Security

Parking Services

N/A

Is your program partnering with an outside organization or using a third-party vendor?(Required)

Yes

Please list planned partners and/or vendors:(Required)

Residential Information

Does your program include overnights?(Required)

Yes

Have you solidified dorm reservations with the DCL?(Required)

Yes

In-progress

In order to reserve housing, you must contact the DCL for housing availability.(Required)

I understand.

How many nights?(Required)

How many counselors/staff will be staying in the dorm?(Required)

Where will participants be staying?(Required)

Name of off-campus housing(Required)

Address of off-campus housing(Required)

Street Address City State / Province / Region ZIP / Postal Code Country

Ratios

Estimated number of BW staff, faculty, or students will be involved? (include all counselors, coaches, staff, etc. for the program)(Required)

Anticipated number of minors (under the age of 18) you think will participate:(Required)

*Max capacity of minors (under the age of 18) you can serve for the program:(Required)

Pricing & Registration

Deposit/Non-Refundable Fee(Required)

*Total Program Fee (Minus Deposit Fee)(Required)

*Registration Begin Date(Required)

This should be the date you want participants to start registering for your program.

*Registration End Date(Required)

This should be the date you want to close your registration.

For programs beginning after August 1st, 2023, I understand that participant registrations must be collected using a University approved platform (Ultracamp). If your registration is not using one of these platforms, you or your DCL representative must contact the DCL, if you haven't done so already.(Required)

I understand.

Staff Compliance

I acknowledge that I, my staff, and anyone else that will have contact with minors during this program, must have an orientation of expectations and requirements of them. If I need assistance with orientation resources, I can/will/should reach out to the DCL.(Required)

Yes, I understand.

I acknowledge that I, my staff, and anyone else that will have contact with minors during this program, will be required to complete the Protecting Youth Training and have a certificate on file with my department, if we have not already done so. If I need assistance with training, I can/will/should reach out to the DCL.(Required)

Yes, I understand.

I acknowledge that I, my staff, and anyone else that will have contact with minors during this program, will be required to get a background check if not already on file. If I need assistance with background checks, I can/will/should reach out to the DCL.(Required)

Yes, I understand.

Policies & Procedures

Will you be transporting minors as a part of the program?(Required)

Yes

I understand that transportation of minors must be done using a university vehicle (or through a BW-approved transportation provider). No personal vehicles may be used for any reason. Anyone responsible for driving university vehicles must have completed the appropriate training. Reservations for transportation can be made through the Purchasing Office. Questions regarding transportation should be directed to Karen Stenger at kstenger@bw.edu or x2726.

Yes, I understand.

Are you allowing medication to be held by campers or staff?(Required)

Yes

If you are allowing medication to be held by camper or staff, do you have a protocol in place for administering medications?(Required)

This protocol should be written down, shared with your staff, and carried out during your program.

Yes

In-progress

Do you have a protocol in place for an emergency situation in which a minor needs medical attention or an emergency happens on or off campus?(Required)

This protocol should be written down and shared with your staff.

Yes

In-progress

Do you have an arrival and dismissal plan for minors to and from the program?(Required)

This plan should be written down, shared with your staff, and carried out during your program.

Yes

In-progress

I understand that all dismissal plans should include pick-up verification (i.e., drivers license and prior approved point of contact – grandparent on the registration form).(Required)

I understand.

By checking this box, I acknowledge that I have completed this form to the best of my ability, have read and will abide by the Baldwin Wallace University Minors on Campus Policy and all applicable requirements set out above.(Required)

Yes, I agree.

Phone

This field is for validation purposes and should be left unchanged.