You must have JavaScript enabled to use this form. In compliance with Emerson's College's Minors on Campus policy I understand and acknowledge that I have received a copy of Emerson College Minors on Campus Policy and Code of Conduct. I understand my obligations under the Policy in my role as an Authorized Adult in a Program involving Minors, and the importance of complying with the Policy in order to ensure that Minors on campus or involved in College-sponsored programs are safe. I hereby agree to comply fully with the Policy, including the Code of Conduct and all Reporting Obligations set forth in the Policy. As an employee/student providing services to minors, I am subject to a criminal background check. My signature confirms that I have read the Code of Conduct Involving Interaction with Minors and agree to follow these guidelines where failure to adhere could result in significant adverse consequences including fines, loss of funding, and negative publicity. I understand that any action inconsistent with this policy or failure to take action mandated by this code may result in disciplinary action. Name Email Signature Option Sign with Cursor Upload Signature Signature Sign above Signature Upload Please upload a document or image file that includes your legal signature (not print). One file only.100 MB limit.Allowed types: gif, jpg, png, bmp, eps, tif, pict, psd, txt, rtf, html, odf, pdf, doc, docx, ppt, pptx, xls, xlsx, xml, avi, mov, mp3, ogg, wav, bz2, dmg, gz, jar, rar, sit, svg, tar, zip. Date Leave this field blank