ALL areas contained within a blue background are filled by the form.
Policy
#
txtInstanceNo
ALL areas within a red border are required fields.
Print
Youth Program Registration Form
hiddenUserID
txtDS
Signatures
Comments:
Close
Legal First Name
Email Address
txt1email
txtLegal1FirstName
txtLegal1LastName
txt1Phone
txt2email
txtLegal2FirstName
txtLegal2LastName
txtLegal2Phone no
Group
Location
Maximum No of Students allowed
Program Details
Legal Last Name
Text Other location
Text Input Program Name
Text other group
Education Camp
Internship
Sports Camp
Volunteering
Other
Selection
Oakland Center
OU Soccer Field
OU Swimming Pool
OU Recreation Center
Other
Selection
Contact Phone #
Program Description:
Name
Overnight Program
Full Day Program
Type
Half Day Program
Begin Date
End Date
If the Program is ongoing, put end date one year from beginning.
From
Participant Age Group in Years
To
NI From Age
NI To age
Numeric Input 490
Primary contact
Monday
TI from M
TI To M
TI Total M
Tuesday
TI from T
TI To T
TI Total T
Wednesday
TI from W
TI To W
TI Total W
Thursday
TI from TH
TI To TH
TI Total TH
Friday
TI from F
TI To F
TI Total F
Saturday
TI from S
TI To S
TI Total S
Sunday
TI from SU
TI To SU
TI Total SU
Start Time
End Time
Total Hours
Days
Additional contact
Youth Program Requestor Details
Program has been approved by the supervisor or Department Head
I understand all updates to the form must be completed 5 days prior to Start Date
I have read and will abide by
Oakland University Youth Protection Policy
Accept Agreement
Electronic Signature:
txtelectronic accept
Approver Name:
txtSponsorEmail
Sponsor Email:
Save
Close
txtOUPDEmail
Submit to OUPD
Forward to email :
Disapprove
LOCK
Unlock
Approve
Forward
Comments by OUPD :
txtRoute
If you have any questions, please contact the Youth Protection/Cleary Act Coordinator at (248) 370-3867 or OUPD at (248) 370-3000.
Click here to download an excel Template
Click here for Authorized adult definition
txtSupervisorName
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