University Program Registration Form

Complete all four steps

If an accommodation is needed in the completion and submission of this form, please contact the Office of Institutional Compliance and Ethics at (208) 426-1258.

Step 1 of 4

25%

Does the University Program accept custody and control of the minor participants as defined below?

Definition of Custody and Control: Accepting supervision over and responsibility for Minors in the absence of their parents or other legal guardians. If no form of contract, waiver, or written assumption of supervision is entered into with a Minor’s legal guardian, there is a presumption that the University Program has not assumed custody and control over a Minor. For programs or activities in which the minors remain under the custody and control of their teachers or other staff from their school or organization or in which the minors are accompanied by their parents or guardians, the program does not accept custody and control.

Yes

Name of University Program(Required)

What College/Division is hosting the University Program?(Required)

Indicate the University College/Division as well as Department/Office that the program is sponsored or supported through.

Program Director Name(Required)

Please provide contact information for the program’s director.

First Last

Program Director Phone Number(Required)

Program Director Email(Required)

Program Contact Name

Please provide information for the program’s primary contact or person we may contact with questions, if different from the Director.

Program Contact Phone Number

Program Contact Email

Please provide an in-depth description of your University Program.(Required)

Program website, if any:

Approximate number of minor participants:(Required)

Age range of minor participants:(Required)

Location(s) of University Program(Required)

Please list the areas on campus where the University Program will be held.

Will the University be providing transportation to minors?(Required)

Yes

If transporting minors, please indicate the need for transportation and method of travel.(Required)

What are the dates of the University Program?(Required)

What time will the University Program begin operations?(Required)

Hours

Minutes

AM/PMAM/PM AM/PM

What time will the University Program end operations?(Required)

Hours

Minutes

AM/PMAM/PM AM/PM

Is there a registration fee for the University Program?(Required)

Note: The following administrative fee structure applies to help ensure appropriate staffing for the Minors on Campus program and to maintain compliance with University policies: $5 per registrant for day-use only programs with a registration fee of $50 or more. 10% of the registration fee for day-use only programs with a registration fee under $50 per registrant (for example, a registration fee of $40 would incur an additional $4 administrative fee). $10 per registrant for any overnight program.

Yes

How much is the fee for the University Program?(Required)

Please provide details of the specific procedures you will have in place to ensure the safety of minors (e.g., How will the minors be dropped off and picked up from the University Program? Will there be a monitored check-in and check-out process? Will at least two adults be present at all times?) The Minors on Campus website provides best practices on safety measures you can implement to prevent minor abuse or inappropriate behavior. The Minors on Campus website is located at: https://www.boisestate.edu/compliance/minors-on-campus/. You can also email a copy of any documented established program procedures to protectionofminors@boisestate.edu.(Required)

Will the minor participants be staying overnight on campus?(Required)

Yes

Some Yes, Some No

Which housing units will minor participants be staying (check all that apply)?(Required)

Chaffee Hall

Driscoll Hall

Honors College/Sawtooth Hall

Keiser Hall

Morrison Hall

Taylor Hall

Towers Hall

University Square

University Suites

Lincoln Townhomes

University Heights Apartments

University Manor Apartments

University Park Apartments

University Village Apartments

Not Booked Yet

Emergency Contact Name(Required)

Please list the appropriate person to contact in case of emergency.

First Last

Emergengy Contact Phone(Required)

Emergency Contact Email(Required)

Is there anything else the Office of Institutional Compliance and Ethics should know about the University Program?

I understand that as the organizer, director, dean, or department chair overseeing a University Program involving minors, it is my duty to ensure that all faculty, staff, and volunteers who will be working with minors have completed a background verification through Human Resources prior to their participation in the University Program in accordance with University Policy 7005 (Background Verifications)(Required)

I agree

I understand that everyone has a duty to prevent minor abuse when possible and immediately report it when suspected. There is no need to investigate or ensure that evidence exists before reporting. If a minor is in imminent danger, call 9-1-1. otherwise, report the incident to either (1) the Department of Public Safety at (208) 426-6911, or (2) the Idaho Department of Health and Welfare at (208) 334-KIDS (5437). After making the mandatory report to either law enforcement or the Idaho Department of Health and Welfare, the information must then also be promptly provided to the Office of Institutional Compliance and Ethics by emailing protectionofminors@boisestate.edu, or by calling (208) 426-1258.(Required)

I agree

I understand that as the organizer, director, dean or department chair overseeing a University Program involving minors, it is my duty to ensure that all Faculty, Staff, and Volunteers who will be working with minors complete the Minor Abuse Prevention Training at least 48 hours prior to the start of the University Program.(Required)

The online training is available at http://bit.ly/2XQKwVS. To request an in-person training, email a request to protectionofminors@boisestate.edu.

I agree

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