ࡱ> ]_\ `bjbjvv 4bjj | | u  8,bddddddu +#d9dzzz@bzbzzzJfzN0z##z#zzddv#| ;: UNIVERSITY OF WYOMING [INSERT EVENT NAME] PRWORA Eligibility Certification The Public Responsibility and Work Opportunity Reconciliation Act (PRWORA) mandates the verification of eligibility for federal public benefits. This University program is federally funded and, therefore, requires verification of eligibility for all attendees. Under PRWORA only individuals who are U.S. Citizens, U.S. Non-Citizen Nationals, or Qualified Aliens (as defined in the attached definitions, which were made available to me before I signed this document). By signing below and attending this public event, I certify under penalty of perjury that I am a US Citizen, US Non-Citizen National, or Qualified Alien, that I am at least 18 years old or older, competent to complete this certification, and that I am signing the document voluntarily. If I am the parent or legal guardian of a minor or dependent adult participant, I am signing and agreeing to the above language for the minor or dependent adult participant and authorizing their participation. I indemnify, release, and hold harmless the University from any claims, damages, or liabilities that may arise from the Universitys reliance on my certification. Participant Printed NameParticipant ( or parent/guardian) Signature PRWORA Definitions [to be Displayed with the Event Attestation Form] U.S. Non-Citizen National (1) A person born in an outlying possession of the United States on or after the date of formal acquisition of such possession; (2) A person born outside the United States and is outlying possessions of parents both of whom are nationals, but not citizens, of the United States, and have had a residence in the United States, or one of its outlying possessions prior to the birth of such person; (3) A person of unknown parentage found in an outlying possession of the United States while under the age of five years, until shown, prior to attaining the age of twenty-one years, not to have been born in such outlying possessions; and (4) A person born outside the United States and its outlying possessions of parents one of whom is an alien, and the other a national, but not a citizen, of the United States who, prior to the birth of such person, was physically present in the United States or its outlying possessions for a period or periods totaling not less than seven years in any continuous period of ten years - (A) during which the national parent was not outside the United States or its outlying possessions for a continuous period of more than one year, and (B) at least five years of which were after attaining the age of fourteen years. The proviso of section (301(g) shall apply to the national parent under this paragraph in the same manner as it applies to the citizen parent under that section. Qualified Alien (1) an alien who is lawfully admitted for permanent residence under the Immigration and Nationality Act [8 U.S.C. 1101 et seq.], (2) an alien who is granted asylum under section 208 of such Act [8 U.S.C. 1158], (3) a refugee who is admitted to the United States under section 207 of such Act [8 U.S.C. 1157], (4) an alien who is paroled into the United States under section 212(d)(5) of such Act [8 U.S.C. 1182(d)(5)] for a period of at least 1 year, (5) an alien whose deportation is being withheld under section 243(h) of such Act [8 U.S.C. 1253] (as in effect immediately before the effective date of section 307 of division C of Public Law 104208) or section 241(b)(3) of such Act [8 U.S.C. 1231(b)(3)] (as amended by section 305(a) of division C of Public Law 104208), (6) an alien who is granted conditional entry pursuant to section 203(a)(7) of such Act [8 U.S.C. 1153(a)(7)] as in effect prior to April 1, 1980, (7) an alien who is a Cuban and Haitian entrant (as defined in section 501(e) of the Refugee Education Assistance Act of 1980), or (8) an individual who lawfully resides in the United States in accordance with a Compact of Free Association referred to in section 1612(b)(2)(G) of this title. (9) Treatment of certain battered aliens as qualified aliens (1) an alien who (A)has been battered or subjected to extreme cruelty in the United States by a spouse or a parent, or by a member of the spouse or parents family residing in the same household as the alien and the spouse or parent consented to, or acquiesced in, such battery or cruelty, but only if (in the opinion of the agency providing such benefits) there is a substantial connection between such battery or cruelty and the need for the benefits to be provided; and (B)has been approved or has a petition pending which sets forth a prima facie case for (i)status as a spouse or a child of a United States citizen pursuant to clause (ii), (iii), or (iv) of section 204(a)(1)(A) of the Immigration and Nationality Act [8 U.S.C. 1154(a)(1)(A)(ii), (iii), (iv)], (ii)classification pursuant to clause (ii) or (iii) of section 204(a)(1)(B) of the Act [8 U.S.C. 1154(a)(1)(B)(ii), (iii)], (iii)suspension of deportation under section 244(a)(3) of the Immigration and Nationality Act [8 U.S.C. 1254(a)(3)] (as in effect before the title III A effective date in section 309 of the Illegal Immigration Reform and Immigrant Responsibility Act of 1996).[1] (iv)status as a spouse or child of a United States citizen pursuant to clause (i) of section 204(a)(1)(A) of such Act [8 U.S.C. 1154(a)(1)(A)(i)], or classification pursuant to clause (i) of section 204(a)(1)(B) of such Act [8 U.S.C. 1154(a)(1)(B)(i)];/ [2] (v)cancellation of removal pursuant to section 240A(b)(2) of such Act [8 U.S.C. 1229b(b)(2)]; (2)an alien (A)whose child has been battered or subjected to extreme cruelty in the United States by a spouse or a parent of the alien (without the active participation of the alien in the battery or cruelty), or by a member of the spouse or parents family residing in the same household as the alien and the spouse or parent consented or acquiesced to such battery or cruelty, and the alien did not actively participate in such battery or cruelty, but only if (in the opinion of the agency providing such benefits) there is a substantial connection between such battery or cruelty and the need for the benefits to be provided; and (B)who meets the requirement of subparagraph (B) of paragraph (1); (3)an alien child who (A)resides in the same household as a parent who has been battered or subjected to extreme cruelty in the United States by that parents spouse or by a member of the spouses family residing in the same household as the parent and the spouse consented or acquiesced to such battery or cruelty, but only if (in the opinion of the agency providing such benefits) there is a substantial connection between such battery or cruelty and the need for the benefits to be provided; and (B)who meets the requirement of subparagraph (B) of paragraph (1); or (4)an alien who has been granted nonimmigrant status under section 101(a)(15)(T) of the Immigration and Nationality Act (8 U.S.C. 1101(a)(15)(T)) or who has a pending application that sets forth a prima facie case for eligibility for such nonimmigrant status. This subsection shall not apply to an alien during any period in which the individual responsible for such battery or cruelty resides in the same household or family eligibility unit as the individual subjected to such battery or cruelty. After consultation with the Secretaries of Health and Human Services, Agriculture, and Housing and Urban Development, the Commissioner of Social Security, and with the heads of such Federal agencies administering benefits as the Attorney General considers appropriate, the Attorney General shall issue guidance (in the Attorney Generals sole and unreviewable discretion) for purposes of this subsection and section 1631(f) of this title, concerning the meaning of the terms battery and extreme cruelty, and the standards and methods to be used for determining whether a substantial connection exists between battery or cruelty suffered and an individuals need for benefits under a specific Federal, State, or local program. *+,LMN ! 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AptosC. Aptos DisplayA$BCambria Math"h*ܧ+ܧ{f3=3=3!203Q@P $P2! xx9o RELEASE, ASSUMPTION OF RISK Bruce Hooper Carrie Hesco Oh+'0 $ D P \ ht|RELEASE, ASSUMPTION OF RISKBruce Hooper Normal.dotmCarrie Hesco3Microsoft Office Word@@a@,f@^sf= ՜.+,D՜.+,\ hp  University of Wyoming3 RELEASE, ASSUMPTION OF RISK Titlex @HGrammarlyDocumentId(5a6b96a0-0406-45e6-930e-7d91b44e82f9  !"#$%&'()*+,-./013456789;<=>?@ABCDEFGHIJKMNOPQRSUVWXYZ[^Root Entry F f`Data 21Table:#WordDocument4bSummaryInformation(LDocumentSummaryInformation8TCompObjr  F Microsoft Word 97-2003 Document MSWordDocWord.Document.89q