UW Recreation- Club Safety Officer Agreement

Safety Officer Agreement
Primary Rec Club:*
Secondary Rec Club:
(if applicable)
Name:*

First NameLast Name
E-mail:*
A. SAFETY OFFICER RESPONSIBILITIES

Each club must designate AT LEAST one Safety Officer, but is encouraged to have more. In order to be a safety officer for your club, you must read and agree to the conditions below. Place a check mark in each box below to indicate you have read and understood each condition.
Read conditions and check each box*

I will ensure that our Club's first aid kit (if applicable) is stocked at all times during club activity. I am also aware that the first aid office is located on the first floor of the IMA Building.I will complete and submit to the Rec Clubs Office within 24 hours an Accident/Injury form, anytime an injury occurs during club activity.I will ensure that the IMA/Rec Clubs Office is contacted ANY TIME an ambulance/EMT is summoned to care for or check on an injured club member, or if a club member is taken to the hospital as a result of an injury sustained during club activity (whether Home or Away)I will ensure that the Emergency Protocols (pdf) is on hand for quick reference at club activities/events.I will ensure that any outdoor activity stops and club members seek shelter indoors if a thunder/lightning storm is approaching. I will then allow 30 minutes after the last sound of thunder or flash of lightning before resuming club activity.I will ensure covid-19 safety policies and procedures are implemented and followed.
B. Additional Safety Protocols

The Department of Recreation provides general Accident/Injury guidelines and Emergency Protocols for clubs. Given that each club operates within varying parameters (i.e. Sailing/Kayak Club on water, Climbing Club in back-country), it may be necessary for your club to provide additional safety protocols.
If your primary club has any additional safety protocols, please list them:
If your secondary club has any additional safety protocols, please list them:
C. Certification Information
Attach current First Aid/CPR certification

Upload a File

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List any additional certifications or training here (i.e. EMT, WFA, WFR, etc.):
D. Statement of Understanding

As a safety officer for my Rec Club (listed above), I have read and understand my responsibilities. With my electronic signature below, I agree to follow all policies and procedures set forth by the Department of Recreation.
Name:*
Student ID Number:
Signature*
Should be Empty:

Safety Officer Agreement

A. SAFETY OFFICER RESPONSIBILITIES

B. Additional Safety Protocols

C. Certification Information

D. Statement of Understanding