UW Recreation- Club Safety Officer Agreement

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

First Name Last 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
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