RISK MANAGEMENT YOUTH INITIATIVE PARENT/GUARDIAN FORMS PACKAGE
RISK MANAGEMENTYOUTH INITIATIVEPARENT/GUARDIANFORMS PACKAGENational Program Planning andDevelopment CommitteeDelta Sigma Theta Sorority, Incorporated1707 New Hampshire Avenue, NWWashington, DC 20009Revised September 2020
Delta Sigma Theta Sorority, IncorporatedRisk Management Manual FormsYOUTH INITIATIVE PARENT/GUARDIAN FORMSAPPENDICES: FORMS AND REFERENCE MATERIALSContentsParent/Guardian Forms Checklist . 2B1.Parent/Guardian Affirmation 3B2.Photograph, Media, and Video Authorization Release Form . 4B3.Youth Code of Conduct . 5B4.Youth Pick-Up Authorization . 7B5a. Parent Waiver and Permission to Transport Youth . 8B5b. Parent Waiver and Permission for Teenage Driver to Transport Youth . 9B6.Off-Site Permission 11B7.Medical Information and Treatment Authorization Packet . 12B8.Medication Authorization Form 19C1.Confidentiality Policy 22C2.Child Abuse Reporting Numbers . 24C3.Youth Sign In/Sign Out Policy . 29C4.Internet Use Policy 30Appendix A. Youth Initiative Virtual Meeting Event Participation Agreement 34Appendix A-Schedule 1. Youth Initiative Virtual Meeting and Publicity Code of Conduct . 36Appendix A-Schedule 2. Media and Publication Release . 37 2020 Delta Sigma Theta Sorority, Inc. This content is protected under US Copyright (17 U.S.C. §§201 et al.) and other federal law and shall not bepublished, reproduced, displayed or otherwise utilized by any party whatsoever without the express written consent of Delta Sigma Theta Sorority, Inc.Violation of Delta’s intellectual property rights will be prosecuted to the full extent of the law.
Revised 09/2020Delta Sigma Theta Sorority, IncorporatedRisk Management Manual FormsParent/Guardian FormsThe forms contained herein have been approved by Delta SigmaTheta Sorority, Incorporated, for use by all Chapters. Tominimize risk and legal liability, Chapters are prohibited frommodifying or altering these forms, except for inserting the nameof the Chapter, youth, parent/guardian, or volunteer. 2020 Delta Sigma Theta Sorority, Inc. This content is protected under US Copyright (17 U.S.C. §§ 201 et al.) and other federal law and shall not be published,reproduced, displayed or otherwise utilized by any party whatsoever without the express written consent of Delta Sigma Theta Sorority, Inc. Violation of Delta’s intellectualproperty rights will be prosecuted to the full extent of the law.
Delta Sigma Theta Sorority, IncorporatedRisk Management Manual FormsRevised 09/2020Page 2PARENT/GUARDIAN FORMS CHECKLISTYouth Participant Name:Date:Appendix B1: Parental/Guardian AffirmationDate Received:Appendix B2: Photograph, Media and Video Authorization FormDate Received:Appendix B3: Youth Code of ConductDate Received:Appendix B4: Youth Pick-up AuthorizationDate Received:Appendix B5(a): Waiver and Permission to Transport YouthDate Received:Appendix B5(b): Parent Waiver and Permission for Teenage Driver to Transport YouthDate Received:Appendix B6: Off-site PermissionDate Received:Appendix B7: Medical Information and Treatment AuthorizationPacket Date Received:Appendix B8: Medication AuthorizationDate Received:Appendix C1: Confidentiality PolicyDate Received:Appendix C2: Child Abuse ReportingNumbersDate Received:Appendix C3: Youth Sign-In/Sign-OutPolicyDate Received:Appendix C4: Internet Use PolicyDate Received:Printed Name of Chapter Member Completing Form:Signature: 2020 Delta Sigma Theta Sorority, Inc. This content is protected under US Copyright (17 U.S.C. §§ 201 et al.) and other federal law and shall not be published,reproduced, displayed or otherwise utilized by any party whatsoever without the express written consent of Delta Sigma Theta Sorority, Inc. Violation of Delta’s intellectualproperty rights will be prosecuted to the full extent of the law.
Revised 09/2020Page 3Delta Sigma Theta Sorority, IncorporatedRisk Management Manual FormsAPPENDIX B1PARENTAL/GUARDIAN AFFIRMATIONI,,herebygivemypermissiontotheChapter of Delta Sigma Theta Sorority, Incorporatedfortoparticipateintheyouth initiative (including planned activities), and I herebyattest, under penalty of perjury, that I have the legal authority to authorize such participation.Printed Name:Signature:Relationship to child:Date:WAIVER AND RELEASEI,, Parent/Guardian, on behalf of(“Participant Minor Child”) do hereby release, waive,discharge, covenant not to sue and agree to hold harmless Delta Sigma Theta Sorority, Incorporated(“DST”), its officers, National Executive Board, employees, members, local Chapters, representatives,agents, affiliates, and assigns (collectively “Releases”), from any and all claims, demands, and actions ofany and every kind directly or indirectly arising out of, or relating in any respect to Participant MinorChild’s participation in theYouth Initiative.My waiver and release of all claims, demands, actions, and liability shall include withoutlimitation, any injury, illness, death, property damage or loss to the Participant Minor Child which maybe caused by any act, or failure to act, by the Releases, unless such injury, illness, death, property damageor loss is a direct result of the willful misconduct of any Releases.I understand that, without limitation of the foregoing, neither Delta, nor the Program, shall beliable and each is hereby released from all claims that may arise from loss or damage to the ParticipantMinor Child’s personal property.Parent/Guardian Signature:Date: 2020 Delta Sigma Theta Sorority, Inc. This content is protected under US Copyright (17 U.S.C. §§ 201 et al.) and other federal law and shall not be published,reproduced, displayed or otherwise utilized by any party whatsoever without the express written consent of Delta Sigma Theta Sorority, Inc. Violation of Delta’s intellectualproperty rights will be prosecuted to the full extent of the law.
Delta Sigma Theta Sorority, IncorporatedRisk Management Manual FormsRevised 09/2020Page 4APPENDIX B2PHOTOGRAPH, MEDIA, AND VIDEO AUTHORIZATION RELEASE FORMI/We,(“Parent/Guardian”), as parent(s)or legalguardian(s) of, give permission forChapter of Delta Sigma Theta Sorority, Incorporated (the “Chapter”) to publish on the Internet or mediastill photographs or moving images, including, if applicable any sound recordings accompanying theimages (“Images”) taken of my child during participation inYouthInitiative Program activities, without payment or any consideration and without notifying me in advance.I/We also give permission for the Chapter to highlight my child’s achievements and activities in efforts topromote the youth initiative program through newspapers, radio, TV, the web, DVDs, displays, brochures,and other types of media without payment or any consideration and without notifying me.I/We understand and agree that these Images will become the property of the Chapter, which shall havecomplete ownership of the Images. I hereby irrevocably authorized the Chapter to publish or distributethese Images for the purpose of publicizing the Chapter’s programs, including theYouth Initiative Program or for any other lawful purpose. Inaddition, I waive any right to inspect or approve the finished product wherein my child’s likeness appears.Additionally, I waive any rights to royalties or other compensation arising out of or related to the use ofthe Images.I/We hereby hold harmless and release and forever discharge the Chapter and any of its officers andmembers; Delta Sigma Theta Sorority, Incorporated; its officers; National Executive Board; employees;members; representatives; agents; and assigns from any and all claims, costs, suits, actions, judgments,and expenses which my child, his/her heirs, representatives, executors, administrators, or any otherpersons acting on his/her behalf have or may have by reason of the use of the Images. This releasespecifically includes, without limitation, a complete release and discharge of any liability by virtue of anyediting, distortion, alteration, or optical illusion, whether intentional or otherwise, that may occur or beproduced in the taking of or editing of said Images, unless it can be shown that such was maliciouslycaused, produced and published solely for the purpose of subjecting my child to conspicuous ridicule,scandal, reproach, scorn and indignity.I/we hereby certify that I/we are the parents/guardians of,authorized legally to give this consent, and do hereby give my/our consent without reservation to theforegoing on behalf of my/our child.Parent/Guardian SignatureDatePrint NameParent/Guardian SignatureDatePrint Name 2020 Delta Sigma Theta Sorority, Inc. This content is protected under US Copyright (17 U.S.C. §§ 201 et al.) and other federal law and shall not be published,reproduced, displayed or otherwise utilized by any party whatsoever without the express written consent of Delta Sigma Theta Sorority, Inc. Violation of Delta’s intellectualproperty rights will be prosecuted to the full extent of the law.
Delta Sigma Theta Sorority, IncorporatedRisk Management Manual FormsRevised 09/2020Page 5APPENDIX B3YOUTH CODE OF CONDUCT1.2.3.4.5.6.7.8.9.10.Respect all participants (other youth and adult volunteers) by not using foul, hurtful orobscene1language or engaging in physical violence, bullying (including cyber-bullying) or otheraggressive behaviors that threaten the safety of others.Respect the property rights of others. This means do not damage or deface the building orproperty within the building where chapter activities are held; do not damage or take the personalproperty of any other participant or volunteer; and do not use Delta’s name or any symbol orlogo (Delta’s intellectual property) on any clothing, books, bags, or other items.Return supplies to their proper place after using them.Clean up all work areas properly.Listen carefully to directions and when someone else is talking.Respect designated quiet areas, such as homework/reading area.Stay within the program’s designated areas within the building.Cooperate and participate in organized activities.Assume full responsibility for all personal belongings. Please leave valuables at home.Do not bring any weapons, cigarettes/drugs, alcohol, or anything illegal to any activity at anytime.Sanctions for Violating Code of ConductBad Language/Abusive Teasing and Related Acts:1st Time: Verbal warning, parent or guardian notified from this point forward2nd Time: Loss of privileges3rd Time: 1-week suspension from program Next occurrence youth is removed from the program.Physical Violence and Other Misconduct:1st Time: Removal from situation, loss of privileges, guardian notified from this point forward Next occurrence youth is removed from the program.Illegal Substances or Dangerous Weapons1set Time: Youth is removed from the program. If a youth is in possession of an illegal substance ordangerous weapon, the police will be notified as well.(Continued on next page)1Cyber-bullying is defined in Appendix C4, which sets out the Internet Use Policy. 2020 Delta Sigma Theta Sorority, Inc. This content is protected under US Copyright (17 U.S.C. §§ 201 et al.) and other federal law and shall not be published,reproduced, displayed or otherwise utilized by any party whatsoever without the express written consent of Delta Sigma Theta Sorority, Inc. Violation of Delta’s intellectualproperty rights will be prosecuted to the full extent of the law.
Delta Sigma Theta Sorority, IncorporatedRisk Management Manual FormsRevised 09/2020Page 6(Student Participant)With my parent or other adult, I have read the Code of Conduct and sanctions for violating the Code.I understand the Code and the sanctions. I will follow the Code of Conduct.SignatureDatePrint Name**************(Parent)I have read and understand the Code of Conduct and sanctions for violating the Code of Conduct. Iunderstand that my child’s compliance with the Code of Conduct is a condition of her/his participationin theprogram. I agree that the sanctions for violating theCode of Conduct are reasonable and will help my child comply.SignatureDatePrint Name 2020 Delta Sigma Theta Sorority, Inc. This content is protected under US Copyright (17 U.S.C. §§ 201 et al.) and other federal law and shall not be published,reproduced, displayed or otherwise utilized by any party whatsoever without the express written consent of Delta Sigma Theta Sorority, Inc. Violation of Delta’s intellectualproperty rights will be prosecuted to the full extent of the law.
Revised 09/2020Page 7Delta Sigma Theta Sorority, IncorporatedRisk Management Manual FormsAPPENDIX B4YOUTH PICK-UP AUTHORIZATION FORMI authorize the persons listed below to pick-up my child from theyouthinitiatives program. For my child’s safety, I understand that all authorized persons on the list below willbe asked to show photo identification before my child is released to them; therefore, I will notify allauthorized persons of this requirement so that they will have photo identification with them when theyarrive to pick-up my child. (Please include names of either parents or guardians on list below).NameHome PhoneRelationshipWork PhoneNameHome PhoneRelationshipWork PhoneNameHome PhoneWork PhoneCell PhoneRelationshipWork PhoneNameHome PhoneCell PhoneRelationshipNameHome PhoneCell PhoneCell PhoneRelationshipWork PhoneCell PhoneBy signing below, I verify that I have read and agree to the Student Pick-Up policies described above andauthorize theChapter to release my child to the personslisted above. I also agree to notify theChapter in writing ofany changes to the above list of authorized persons.Mother/Guardian SignatureDateFather/Guardian SignatureDate 2020 Delta Sigma Theta Sorority, Inc. This content is protected under US Copyright (17 U.S.C. §§ 201 et al.) and other federal law and shall not be published,reproduced, displayed or otherwise utilized by any party whatsoever without the express written consent of Delta Sigma Theta Sorority, Inc. Violation of Delta’s intellectualproperty rights will be prosecuted to the full extent of the law.
Delta Sigma Theta Sorority, IncorporatedRisk Management Manual FormsRevised 09/2020Page 8APPENDIX B5(a)PARENT WAIVER AND PERMISSION TO TRANSPORT YOUTHName of Child:Event:Location:Driver:I give permission for my child/charge (“child”) to be transported in a motor vehicle driven by theindividual identified to an event at the specified location on the date indicated. I understand that my childis expected to follow all applicable laws regarding riding in a motor vehicle and is expected to follow thedirections provided by the driver.I have read, understand, and discussed with my child that:(1) They will be traveling in a motor vehicle driven by an adult and they are to wear theirsafety-belt while traveling.(2) They are expected to respect the vehicles they ride in, and the person they travel withduring the trip.(3) Riding in a motor vehicle may result in personal injuries or death from wrecks,collisions or acts by riders, other drivers, or objects; and(4) They are to remain in their seats and not be disruptive to the driver of the vehicle.I recognize that by participating in this activity, as with any activity involving motor vehicle transportation,my child may risk personal injury or permanent loss. I hereby attest and verify that I have been advised ofthe potential risks, that I have full knowledge of the risks involved in this activity, and that I assume anyexpenses that may be incurred in the event of an accident, illness, or other incapacity, regardless of whetherI have authorized such expenses.As a condition for the transportation received, I, for myself, my child, my executors, and assigns, furtheragree to release and forever discharge Delta Sigma Theta Sorority, Incorporated and theChapter from any claim that I might have myself or that I could bringon my child’s behalf with regard to any damages, demands or actions whatsoever, including those basedon negligence, in any manner arising out of this transportation. I have read this entire waiver andpermission form, fully understand it, and agree to be legally bound by its terms.Parent/Guardian SignatureDatePrint Name 2020 Delta Sigma Theta Sorority, Inc. This content is protected under US Copyright (17 U.S.C. §§ 201 et al.) and other federal law and shall not be published,reproduced, displayed or otherwise utilized by any party whatsoever without the express written consent of Delta Sigma Theta Sorority, Inc. Violation of Delta’s intellectualproperty rights will be prosecuted to the full extent of the law.
Delta Sigma Theta Sorority, IncorporatedRisk Management Manual FormsRevised 09/2020Page 9APPENDIX B5(b)PARENT WAIVER AND PERMISSION FOR TEENAGE DRIVER TO TRANSPORT YOUTHALL TEENAGE DRIVERS MUST HAVE A NON-PROVISIONAL DRIVER’S LICENSEName of Child:Event:Location:Student Driver:I give permission for my child/charge (“child”) to be transported in a motor vehicle driven by theindividual identified to an event at the specified location on the date indicated. I understand mychild is expected to follow all applicable laws regarding riding in a motor vehicle and is expectedto follow the directions provided by the driver.I have read, understand, and discussed with my child that:(1) They will be traveling in a motor vehicle driven by a teenage driver and they are to weartheir safety-belt while traveling.(2) They are expected to respect the vehicles they ride in, and the person they travel with duringthe trip.(3) Riding in a motor vehicle may result in personal injuries or death from wrecks, collisionsor acts by riders, other drivers, or objects; and(4) They are to remain in their seats and not be disruptive to the driver of the vehicle.I recognize that by participating in this activity, as with any activity involving motor vehicletransportation, my child may risk personal injury or permanent loss. I hereby attest and verify thatI have been advised of the potential risks, that I have full knowledge of the risks involved in thisactivity, and that I assume any expenses that may be incurred in the event of an accident, illness, orother incapacity, regardless of whether I have authorized such expenses.As a condition for the transportation received/provided, I, for myself, my child, my executors andassigns, further agree to release and forever discharge Delta Sigma Theta Sorority, Incorporatedand theChapter from any claim that I mighthave myself or that I could bring on my child’s behalf with regard to any damages, demands oractions whatsoever, including those based on negligence, in any manner arising out of thistransportation. I have read this entire waiver and permission form, fully understand it, and agreeto be legally bound by its terms.Date 2020 Delta Sigma Theta Sorority, Inc. This content is protected under US Copyright (17 U.S.C. §§ 201 et al.) and other federal law and shall not be published,reproduced, displayed or otherwise utilized by any party whatsoever without the express written consent of Delta Sigma Theta Sorority, Inc. Violation of Delta’s intellectualproperty rights will be prosecuted to the full extent of the law.
Revised 09/2020Page 10Delta Sigma Theta Sorority, IncorporatedRisk Management Manual Forms(Student Participant)With my parent or other adult, I have read the Code of Conduct and sanctions for violating the Code.I understand the Code and the sanctions. I will follow the Code of Conduct.SignatureDatePrint Name**************(Parent)I have read and understand the Code of Conduct and sanctions for violating the Code of Conduct. Iunderstand that my child’s compliance with the Code of Conduct is a condition of her/his participationin theprogram. I agree that the sanctions for violating theCode of Conduct are reasonable
PARENT/GUARDIAN FORMS PACKAGE National Program Planning and Development Committee . Initiative Program activities, without payment or any consideration and without notifying me in advance. . (Student Participant) With my parent or other adult, I have read the Code of Conduct and sanctions for violating the Code.
81. Risk Identification, page 29 82. Risk Indicator*, page 30 83. Risk Management Ω, pages 30 84. Risk Management Alternatives Development, page 30 85. Risk Management Cycle, page 30 86. Risk Management Methodology Ω, page 30 87. Risk Management Plan, page 30 88. Risk Management Strategy, pages 31 89. Risk
the Youth Coordinator getting to know a youth, developing trust, becoming familiar with the youth’s culture, and focusing on what the youth hopes to achieve during their time together. During this phase, the Youth Coordinator is able to learn what resources will best suit the youth and what level of support will help the youth succeed.
Risk is the effect of uncertainty on objectives (e.g. the objectives of an event). Risk management Risk management is the process of identifying hazards and controlling risks. The risk management process involves four main steps: 1. risk assessment; 2. risk control and risk rating; 3. risk transfer; and 4. risk review. Risk assessment
Tunnelling Risk Assessment 0. Abstract 1. Introduction and scope 2. Use of risk management 3. Objectives of risk assessment 4. Risk management in early design stages 5. Risk management during tendering and contract negotiation 6. Risk management during construction 7. Typical components of risk management 8. Risk management tools 9. References .
Risk Matrix 15 Risk Assessment Feature 32 Customize the Risk Matrix 34 Chapter 5: Reference 43 General Reference 44 Family Field Descriptions 60 ii Risk Matrix. Chapter 1: Overview1. Overview of the Risk Matrix Module2. Chapter 2: Risk and Risk Assessment3. About Risk and Risk Assessment4. Specify Risk Values to Determine an Overall Risk Rank5
Standard Bank Group risk management report for the six months ended June 2010 1 Risk management report for the six months ended 30 June 2010 1. Overview 2 2. Risk management framework 3 3. Risk categories 6 4. Reporting frameworks 8 5. Capital management 10 6. Credit risk 17 7. Country risk 36 8. Liquidity risk 38 9. Market risk 42 10 .
MAKING OUR YOUTH ALIVE ONE YEAR ADVENTIST YOUTH SOCIETY PROGRAM FORMAT PREPARED BY ARDEN JUNE GUILLERMO DUMPASAN . 3 ADVENTIST YOUTH SOCIETY The Adventist Youth Society is a department of the church through which the church works for and through her youth. OBJECTIVES: 1.
current trends and techniques in the fi eld of analytical chemistry. Written for undergraduate and postgraduate students of chemistry, this revised and updated edition treats each concept and principle systematically to make the subject comprehensible to beginners as well as advanced learners. FEATURES Updated nomenclature Addition of tests for metals based on fl ame atomic emission .
