Health & Safety Form

Emergency Checklist

Checklist for Tutors and people using WEA building *

I agree

I know where the emergency exits are I know the wardens duties, evacuation procedure and assembly point I know what to do in an earthquake I know where the Defibrillator is I know where the Alarm points are I know where the nearest fire extinguisher is I know where there is a first aid kit I know where the nearest telephone is I am familiar with the hazards in the building

Information for Tutor to give to participants prior to activity *

I agree

Location of Toilets Identification of any hazards and precautions Evacuation procedure, locaation of emergency exits and assembly point Location of Fire Extinguisher What to do in an earthquake Location of nearest telephone

I have read and agree that I understand the Emergency Checklist and upon ticking this box is the equivalent of a signature

First Name

Last Name

Organisation

Date

I have read and agree that I understand the Emergency Checklist and upon ticking this box is the equivalent of a signature

Information for Tutor to give to participants prior to activity *

I Agree

First Name

Last Name

Organisation

Date

I have read and agree that I understand the Emergency Checklist and upon ticking this box is the equivalent of a signature

Emergency Checklist

Programmes and Workshops

CONTACT

WEBSITE

OFFICE HOURS