2020 Youth Programs Registration Form

Youth Program Information

A youth program is a program or activity designed for non-Georgia Tech student minors organized and run by Georgia Tech, or organized and run by third-party entities utilizing Georgia Tech facilities.  Some examples of youth programs include, but are not limited to: day and overnight camps; tutoring/mentoring in local schools; Internships or shadowing experiences for a minor in labs/research facilities.

 

* The program name must match space reservation requests, and facilities use agreement if applicable.
*The name of the organizing entity must match on the registration form, facilities use agreement and certificate of insurance.
Please upload your Certificate of Insurance. Click here to see the COI requirements found in the Facilities Use Agreement.
Files must be less than 2 MB.
Allowed file types: pdf doc docx.

Who is the facility contact for the location of the youth program
(http://www.space.gatech.edu/sites/default/files/documents/GT_Campus_Buildings.pdf):

*The description should serve as a brief summary of the purpose of the program, and include the number of times the program occurs (Ex: Program occurs once a week for 8 weeks over the summer, or, program occurs once in the fall and once in the spring).
*The schedule must include all dates, requested locations, and include all projected activities and program times. All time during the program must be accounted for within the submitted schedule. EX: If the program occurs overnight, “lights out” and when participants are expected at breakfast must be included. The schedule must also note if any participants will interact with any of the following: 3D printing, animal dissections, chemical and/or biological agents, soldering or other heating elements, and/or utilization of a laser. Georgia Tech Environmental Health and Safety approval or exemption may be required prior to Youth Programs approval. If the same program occurs multiple times you can indicate this on the schedule.
Files must be less than 2 MB.
Allowed file types: jpg jpeg txt pdf doc docx ppt pptx xls xlsx.

Youth Programs are required to submit registration forms at least 30 days in advance of the program start date. If there are extenuating circumstances, please reach out to youthprograms@gatech.edu and cc’ the facility manager in the communication.

For multiple programs use start date of first program and end date of last program. Programs can only register for the calendar year.
*Environmental Health and Safety approval or exemption may be required for activities in Georgia Tech laboratories.

Youth Program Location (please include name of location and address)

Campus:
Street Address, City, State

Participant Supervision Information

The Georgia Tech Youth Programs Policy requires Appropriate staffing and supervision ratios by age range in accordance with American Camp Association standards. Generally, one-on-one interactions with minors are prohibited. If one‐on‐one interaction is required, it will take place in open, well illuminated spaces or rooms with windows observable by other authorized adult or program staff, unless the one‐on‐one interaction is expressly authorized by the program administrator or is being undertaken by a health care provider.

 

*Ages or grade levels are acceptable for this field.
*Ages or grade levels are acceptable for this field.

Program Contact Information

If the youth program is being organized by a third-party a representative of that entity must be listed as the primary and on-site contacts. 

 



Youth Program Requirements Reminder
All youth programs must consider and meet the following criteria in the planning of the program:

(By checking off each box you attest to fulfilling the requirements. If you are in doubt please contact our office youthprograms@gatech.edu for further guidance.)

Accept Policy Terms
Policy Terms
You may also read and print the policy from the Georgia Tech policy library here: Youth Programs at Georgia Tech Policy
This field should be completed if the youth programs registration form was completed and submitted on behalf of another person.