Camp Crosley Voluntary Disclosure Statement

Have you ever been convicted of any crime relating in any manner to children and/or your conduct with them?(Required)
Have you ever been adjudged liable for civil penalties or damages involving sexual or physical abuse of children?(Required)
Are you now or have you ever been subject to any court order involving sexual or physical abuse of a minor, including, but not limited to a domestic order or protection?(Required)

The employee acknowledges they are free from claim from any incident that may harm a child in any way including: indecent assault and battery on a minor, indecent assault and batter on an individual with an intellectual disability, rape, rape of a child under sixteen with force, assault with intent to commit rape, kidnapping of a child under sixteen with intent to commit rape, distribution and trafficking of narcotics or other controlled substances, intent to commit any of the above crimes. The release of any information here is voluntary but must be truthful and accurate. The employee understands that any act that endangers a child is not tolerated in accordance to the employee handbook. Any Employee or volunteer who is determined, after an investigation, to have engaged in sexual misconduct in violation of this policy will be subject to disciplinary action up to and including discharge. Any employee or volunteer involved in a reported incident of sexual misconduct or child abuse may be immediately relived of responsibilities that involve interaction with minors or may be suspended. Reinstatement of employees or volunteers involved in a reported incident of child abuse shall occur only after all allegations of child abuse have been resolved.
MM slash DD slash YYYY