Registration Packet

Program Directors must submit all necessary forms to the Office of Safety and Risk Management 30 days prior to the start of a Covered Program. Please submit all completed forms in one file/packet via upload to UTC Learn, email or Internal Mail at Dept. 3904.


 

Required Registration Form

Programs for Minors Registration Form (FORM A) This registration form gives us the information we need to know in order to determine the safety of the program, the communication and emergency plans, and other pertinent information about each Covered Program.  This form is a fillable PDF form, but you may also handwrite your responses.  We have instructions prepared to help you complete this form, but please call our office if you need further assistance.

Each registration form must be signed by both the Program Director or Administrator and their Supervisor or Dean. 

 

Programs must turn in the following information for each Covered Adult in their program:  

Tennessee Law on Mandatory Reporting of Child Abuse and Child Sexual Abuse acknowledgement (FORM C)  

Standards of Conduct for Covered Adults (FORM E) 

Fair Credit Reporting Act Authorization and Consent to Release Information Form (FORM H)

Government Issued Photo ID for each Covered Adult (attach this to the background check form)

Proof of Child Protection Training Completion for each Covered Adult (print training certificates or training sign-in sheet and include in packet)


For third party organizations only:

If a third party organization contracts with the University to hold a program or event on our property, Form D1 must be signed by that organization prior to the event. 

Release, Hold Harmless and Indemnification Agreement (FORM D1) 


Programs that include strenuous activity

For programs that include strenuous activity, these additional forms are required for each camp participant. Program Directors should keep these forms on hand for the duration of the camp.  At the completion of camp, these forms may be delivered to the Safety & Risk Management office, or they may be scanned and emailed to Faith-Garner@utc.edu.

Medical Information and Medical Treatment Release and Authorization Form (FORM B)

Authorization for Self-Administration of Prescription Medication (FORM B1)

Authorization for Dispensation of Over-the-Counter Medication (FORM B2)

Release, Hold Harmless and Indemnification Agreement (FORM D)


Requests for Exception

Some exceptions to the requirements of this policy may be requested for certain circumstances. Contact our office to discuss any concerns or programs that may require such an exception.   

A Program Director using a large number of volunteers in their program may request an exception by completing Form F and sending it to the Designated Official well in advance of the program occurrence.  

A Program Director find themselves in exceptional circumstances may request a temporary exception by completing FORM G and sending it to the Designated Official before use of exception. 

A Program Director may request a transportation exception from the Designated Official if circumstances deem it essential to the operation of program.  If the exception is granted, each camp participant must complete Form F.

A Program Director of an Independent Study may request an exception to allow this interaction with a minor. If the exception is granted, the student's parents or legal guardians must complete Form J.

Request for Exception to SA 575 Requirement of Criminal Background Checks and Training for Volunteers (FORM F)

Notification of Exceptional Circumstances Requiring Exception to SA 575 (FORM G)

Independent Study Program Waiver (Form J) 


Other Forms:

The following forms are not required, but might be helpful as you build your registration packet.  

Camp Staff Worksheet (Form A1) This form may be used to help Program Leads compile the required paperwork for each Covered Adult working with their program.
Training Verification (Form A2)  This form should be used to verify Child Abuse Training led by the Program Lead.  This training must strictly follow the presentation created by UT System Human Resources.
Camp Participant Form Verification (Form A3) This form should be completed to verify that all required forms have been received for all camp participants attending camps involving strenuous activity. 
Volunteer Verification Form (Form F1) This form should only be used if your program has been granted an exception via the Request for Exception to SA 575 Requirement of Criminal Background Checks and Training for Volunteers (FORM F) above.


Questions?  Please contact us. 

Program Coordinator for UTC Designated Official:  Faith Garner, 423-425-5741

Email:  Faith-Garner@utc.edu
Internal Mail:  Dept. 3904
Fax:  423-425-2176