Below are a few resources that provide sample diversity statements that can be included on a course syllabus.

Please also see the sample statement below written by a professor to be inclusive of absences for various reasons by students:

Excused absences require written documentation in advance (or ASAP afterward) from Bailey Health Center, Deans Office, or Athletics coach. If your religious observances require an absence from class or accommodation for coursework, you should talk to Professor X within the first 2 weeks of the semester. Professor X will consider other possible excused absence types in advance, if necessary, and will provide you with her written permission for any additional type of excused absence. Simply e-mailing Professor X saying that you are sick or otherwise unable to attend class does not constitute an excused absence; you should provide appropriate and timely documentation for any absence to count as excused.