Activity Risk Assessment – Off Campus Experiences

All school rules apply during the learning trip. Although precautions are taken it is important to acknowledge that each activity involves risk. Please see the completed risk assessment below.

Parents should keep this form because it contains important contact information.

Name of Student*

Email Address*

Activity*

Location (full address)*

Date of Activity*

Time of Day*

Name of ISY faculty activity supervisor*

Contact Details*

Note: The ISY faculty supervisor will accompany the students on this off-campus activity (or s/he will have authorized an approved non-ISY faculty supervisor)

Transportation Details

The faculty supervisor should take a 1st aid kit.

Adult supervisor/organization (if non-ISY faculty)

When completing the risk assessment keep in mind risks such as: vehicle accident, crime, injury, natural disasters, lost student, disorderly individuals. Students should complete this form and seek approval from the activities director. Use as many boxes as you need (create more if you need them). Note: When off campus, students should always be accompanied by other students.

Risk Assessement

Click the '+' button to add more rows

Concern	Risk Level	Nature of The Risk	Action taken to Reduce Risk	Response Action	Notes

Approval Code

* Only for Supervisors

Approval Process

The Activities Coordinator or the Service Learning Coordinator has established contact with and approved of the off-campus adult supervisor/organization (if non-ISY faculty)*

Yes
No

ISY faculty activity/project supervisor*

Yes
No

Activities Coordinator (Darren Harp)*

Yes
No

Comments

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