ROTARY INTERNATIONAL – DISTRICT 5100
Youth Protection Policy
Club Compliance Certification
Under the District 5100 Youth Protection Policy, the president of a club participating in the District Youth Exchange Program shall certify to the district that the club will comply with the District Youth Protection Policy for the upcoming Rotary year.
Instructions: Club Presidents
If you will be participating in Youth Exchange during the 2024-25 year, please complete this certification and submit it in duplicate to your in July and retain a copy for your records.
Rotary Club of: ______________________________________________________________
2024-25 President: ___________________________________________________________
Address: ____________________________________________________________________
City: ________________________ State: _____ Zip: _____
Phone: ______________________ Email: _________________________________________
CLUB CERTIFICATION
I, ___________________________________, 2024-25 Club President, certify that the Rotary Club of _____________________________________ will comply with the District 5100 Youth Protection policy during the 2024-25 Rotary year.
_________________________________________ Date: _____________________
2024-25 President (Sign Above)
Rotary International District 5100
6700 SW 105th Ave, Beaverton, OR 97008