Staff Child Protection Declaration
Please complete this form to acknowledge your understanding and commitment to our organization's child protection policies.
Full Name
*
First Name
Last Name
Position or Job Title
*
Email Address
*
example@example.com
Have you read and understood the organization's Child Protection Policy?
*
Yes
No
Do you agree to comply with all child protection policies and report any concerns immediately?
*
Yes, I agree
No
Have you ever been the subject of any child protection concerns, investigations, or disciplinary actions?
*
No
Yes (please provide details below)
If you answered 'Yes' to the previous question, please provide details:
Signature (please sign below to confirm your declaration)
*
Date
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Submit Declaration
Submit Declaration
Should be Empty: