Compliance Verification Form | Youth Protection | Washington University in St. Louis

At conclusion of a program, program administrators are asked to complete the Compliance Verification Form located below. This form includes information about total number of minors and program staff, names of program staff, and verifies that all required forms were collected and any incidents were reported using committee procedures.

The Youth Protection Oversight Committee will review the information provided on the Compliance Verification Form and follow-up with program administrators regarding any questions or concerns.

A list of key definitions for using this form is available here.

Youth Protection Program Compliance Verification Form

Program name *

WashU department sponsoring the program *

Program administrator name *

Program administrator title *

Program administrator campus phone *

Program administrator campus email *

Please indicate any changes that need to be made to program type, start and end dates, modality, transportation, location or other program details from your original program registration. If no changes need to made please type “No changes” in the text box.

Actual number of minors that participated in the program. *

Actual number of program staff that participated in the program. *

Upload final list of program staff *

Maximum file size: 51.2MB

File must include first name, last name, email address, and home address for all program staff and be in an Excel format. Please separate information into columns.

Were applicable liability waivers and releases received for all minors that participated in the program?

Yes

If no, please explain.

Do you have any incidents involving minors that have not been reported to the committee?

Yes

Information about incident reporting is available here: https://youthprotection.wustl.edu/incident-reporting.

If yes, please briefly explain the incident(s) and immediately complete the Youth Protection Incident Form available here: https://youthprotection.wustl.edu/incident-reporting/incident-report/

Do you have any questions or concerns the Youth Protection Oversight Committee can address for you?

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