2006-2007

VISION Home and Community Program

Child Protection Screening – Statement of Responsibility

All participants must read and sign below.

We recognize and acknowledge that because many of the Educators in the Vision Home and Community Program (HCP) are not full-time teachers, these people may or may not have received child-protection background screening. Vision HCP takes responsibility for screening all Resource Consultants. We will also provide an AVERT Screening free of charge for any other Mentor or Educator who has so requested by completing the appropriate section of the Vision HCP Educator Application. If an Educator/Mentor has passed or failed or refused a Child Protection Screening by the Delta County School District, that information will be available to you. Ultimately, however, it is your responsibility to assure yourself of the backgrounds of people with whom you trust yourself and/or your child.

I acknowledge my choice and my responsibility in assessing the safety of any persons who are part of my or my child’s education within the Vision HCP. Vision HCP will not be held accountable financially or otherwise for the consequences of my personal choices.

Name of Learner: _______________________________________

Signature of Learner: __________________________ Date:________________

Name of Parent/Guardian: ________________________________

Signature of Parent/Guardian; ________________________ Date: __________