Minors on Campus - Post-Program Reporting Form

Program Name:

Program Start Date:

Program End Date:

Program Location:

Program Director:

Program Administrator:

Number of Participants:

Please upload a copy of your roster:

Please upload a copy of your check-in/out sheet:

Please upload a copy of completed participant forms (excel spreadsheet):

Please upload a copy of all Authorized Adults who participated in your program:
(Authorized Adult: A person, paid or unpaid, who may have direct contact, interact with, treat, supervise, chaperon, or otherwise oversee minors.)

Were there any injuries or disciplinary incidents?

If yes, please upload a copy of the incident description: