1. Club Identification & Purpose

Please name and identify the club participating in this risk assessment. Provide current contact information, the purpose of the club and the types of activities that will suggest the potential hazards for which club members may need to learn risk management techniques. Once you have completed this survey, your group will be contacted either by SGA or by Risk Management if additional information is needed. Please contact safety@uvm.edu with any questions regarding this survey.

List the project/club name and contact information. If your club does not have a designated safety coordinator, then the responsibilities will be managed by the club president for coordinating safety trainings and communicating safety policy & protocol that impacts the club.

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* 1. List the project/club name and contact information. If your club does not have a designated safety coordinator, then the responsibilities will be managed by the club president for coordinating safety trainings and communicating safety policy & protocol that impacts the club.

Provide purpose of club (from Constitution).

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* 2. Provide purpose of club (from Constitution).

Provide details of planned club activities & events that may require risk assessment. Please specify key steps that may include exposure to physical hazards (ex: welding, work with electricity, spray painting, work at heights of greater that 4 feet, etc), chemical use, water hazards, etc.

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* 3. Provide details of planned club activities & events that may require risk assessment. Please specify key steps that may include exposure to physical hazards (ex: welding, work with electricity, spray painting, work at heights of greater that 4 feet, etc), chemical use, water hazards, etc.

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