LYLC 2017 Teacher and School Staff Registration
Teacher and School Staff Registration Form for the Latin American Association's 18th annual Latino Youth Leadership Conference.
**Please note** Each teacher that plans to attend the conference will need to fill out the form below. Teachers who are not registered will not be able to attend the conference.
Your Email Address
Middle or High School?
Address Line 2
State / Province / Region
Postal / Zip Code
Antigua and Barbuda
Bosnia and Herzegovina
British Indian Ocean Territory
Central African Republic
Democratic Republic of the Congo
Republic of the Congo
Papua New Guinea
Saint Kitts and Nevis
Saint Vincent and the Grenadines
Sao Tome and Principe
Trinidad and Tobago
United Arab Emirates
United States Minor Outlying Islands
Virgin Islands, British
Virgin Islands, U.S.
How many students are you planning to bring?
Is this your first LAA Latino Youth Leadership Conference?
If "NO", please tell us how many LAA LYLC the school has attended in the past.
How many parent chaperones are you bringing with you?
Enter a number between
What is your t-shirt size?
Kennesaw State University - Staff & Volunteer Code of Conduct
Program: 18th Annual Latino Youth Leadership Conference
Kennesaw State University is committed to the safety and well-being of minors. Authorized Individuals staff and volunteers should be positive role models and treat others with respect, courtesy and dignity. Authorized staff and volunteers must abide by all Kennesaw State University and University System of Georgia policies and state and federal law.
As an authorized staff or volunteer working in programs for minors, I hereby agree as follows:
• I will maintain appropriate physical boundaries at all times.
• I will immediately report any reasonable suspicion or knowledge of abuse of a minor to the KSU Department of Public Safety and Policy (470-578- 6666) and the Georgia Department of Human Services (1-855-GACHILD) and the Program Sponsor or appropriate program individual who can take immediate action.
• I will not touch or speak to a minor in a sexual or other inappropriate manner.
• If one-on-one interaction is required it will take place in an open, well-illuminated space where I am observable by other volunteers or program staff.
• I will not meet with minors outside of established program locations or outside of established times.
• I will not invite minors to my home or other private location or accept their invitations for the same.
• I will not make sexual comments, tell sexual jokes or allow minors to access sexually explicit materials.
• I will not engage or allow minors to engage me in romantic or sexual conversations.
• I will not engage in private communications with minors to include communications via text messaging, e-mail, phone, internet chat, on-line games or other forms of social media.
• I will not accept or give gifts to minors without the knowledge of their parents or guardians.
• I will not inflict any physical or emotional abuse on minors to include, but not limited to striking, humiliating, ridiculing, or degrading minors.
• I will not use, possess or be under the influence of alcohol or illegal drugs at any time while working with minors.
• I will not provide or knowingly allow minors to possess or consume alcohol, tobacco, or illegal drugs.
• I will not use profanity, vulgarity, or harassing language in the presence of minors at any time.
• I will not provide transportation to minors unless doing so is an acknowledged component of the Program. When transporting minors, more than one volunteer or program staff must be present in the vehicle, except when multiple children/teens will be in the vehicle at all times through the transportation.
By clicking this agreement confirms that I have read and understand this Code of Conduct. My signature further confirms that I agree to abide by this Code of Conduct. Failure to abide by this Code of Conduct may result in sanctions against me, including but not limited to, termination and/or criminal prosecution.
<- Click here to accept the staff & volunteer code of conduct agreement.
Kennesaw State University Volunteer Program
Kennesaw State University is self-insured through the Department of Administrative Services against state tort claims. This coverage is extended to KSU volunteers who are part of a structured program organized, controlled and directed by a Kennesaw State University Department for the purpose of carrying out the functions of the University. The liability coverage is for injuries and/or property damage volunteers may cause others while acting in the course of their official volunteer duties. Liability coverage does not apply when volunteers deviate from the course of their volunteer duties.
Kennesaw State University does not provide volunteers with any accident or medical insurance. Volunteers are not eligible or entitled to any employee benefits. Volunteers are not covered by worker's compensation laws in connection with their officially approved volunteer activities. If the volunteer activities involve the use of the volunteer's personal vehicle, no comprehensive or collision coverage would be provided to their personal vehicles.
Departments that wish to utilize volunteers for the purpose of carrying out the functions of their department must briefly describe what benefit the University derives from their volunteer program and complete the Volunteer Agreement Form. The Volunteer Agreement Form is to include signatures as required and acceptance of the responsibilities associated with this agreement. The volunteer agreement form will establish the guidelines and description of duties for the structured volunteer program.
The following forms are needed to be in compliance with the structured volunteer program:
1. The Kennesaw State University Volunteer Agreement form
2. The Kennesaw State University Volunteer Services Description form
Submit the volunteer agreement and description of duties forms via email to: email@example.com. The approval will be sent to the Dean or Director.
If there are any questions regarding the structured volunteer agreement or additional information is needed, email firstname.lastname@example.org
<- Click here to accept the KSU volunteer program agreement.
AGREEMENT FOR VOLUNTEER SERVICES
I, agree to work as a volunteer at the Latino Youth Leadership Conference at Kennesaw State University from November 4th, 2017 until November 4th, 2017.
I agree that services are offered strictly on a volunteer basis. I understand that I will not be paid or compensated in any way for my services by KSU, nor will I be considered an employee of KSU for any purpose. I understand that I am not entitled to any worker’s compensation.
I agree that my participation in the activities outlined in the attached Description of Volunteer Duties (which is part of this agreement) is not in exchange for any consideration (i.e. payment, employment or the promise of either in the future).
I understand that KSU is self-insured through the Department of Administrative Services against state tort claims. This coverage is provided for volunteers in programs organized, controlled and directed by KSU for the purposes of carrying out the functions of KSU. I UNDERSTAND THAT COVERAGE DOES NOT APPLY WHEN I DEVIATE FROM THE COURSE OF MY VOLUNTEER DUTIES.
I release and hold harmless the Board of Regents of the University Systems of Georgia, Kennesaw State University, their members, employees, agents and authorized representatives from all losses, damages, costs, and expenses, claims, demands, rights and causes of action resulting from any personal injury, death, or damage to property arising out of my volunteer activities.
<- Click here to accept agreement for volunteer services.
Additional Comments or Concerns
I am aware that
ALL TEACHERS from my school must register individually.
I am aware that
ALL STUDENTS from my school must register individually.
I am aware that
I MUST bring all my students' authorization forms in order for them to attend the conference.
Do Not Fill This Out