University of Delaware Protection of Minors Policy Participant Roster Form Directions: Program Organizers are responsible for maintaining a roster of each. Type the requested information for each participant on the form An accurate roster must be provided to the Office of Equity and Inclusion upon request. Program Name: Program Organizer: Dates of Program: Date Form Last Updated: Name Date of Birth Permission Parent or Guardian: Parent or Guardian: In Case of Emergency: In Case of Emergency: Slip/Waiver Name Name Phone John 07/01/1743 Submitted Jane 123-456-7890 Joe 999-999-9999 Name Date of Birth Permission Parent or Guardian: Parent or Guardian: In Case of Emergency: In Case of Emergency: Slip/Waiver Name Name Phone
University of Delaware Protection of Minors Policy Participant Roster Form Directions: Program Organizers are responsible for maintaining a roster of each. Type the requested information for each participant on the form An accurate roster must be provided to the Office of Equity and Inclusion upon request. Program Name: Program Organizer: Dates of Program: Date Form Last Updated: Name Date of Birth Permission Slip/Waiver Parent or Guardian: Name Parent or Guardian: In Case of Emergency: Name In Case of Emergency: Phone John 07/01/1743 Submitted Jane 123-456-7890 Joe 999-999-9999 Name Date of Birth Permission Slip/Waiver Parent or Guardian: Name Parent or Guardian: In Case of Emergency: Name In Case of Emergency: Phone
Participant-Roster-y95v1r.docx