Adventist Outdoors Activity Notification Form

Adventist Outdoor Activity Notification

Contact

ADVENTIST OUTDOORS ACTIVITY NOTIFICATION

This form is emailed to the NNSW Youth Department to record your upcoming event. If there are any issues with the proposed event you will be contacted. Thanks for all you do with Pathfinders and/or Adventurers in our conference!

Pathfinder or Adventurer Club Name

Types of Activities – eg. abseiling. rock climbing, bushwalking or kayaking

Does this activity require a qualified instructor? (Events like bushwalking, abseiling, kayaking, caving or water based activities need to have an appropriately certified person run them)

Yes

Name of Qualified Instructor

Authority from Local Church Board (Have you had this event passed by the church board and put on the official church calendar?)

Yes

Emergency Contact Details Distributed (Have parents or guardians been given the emergency contact details?)

Yes

Base and Emergency Contact Details

This person will notify police or agreed emergency plan if not contacted by the deadline.

Emergency Contact Deadline

First Name

Last Name

Mobile

Additional Contact Number

Group Leader

First Name

Last Name

Mobile

Additional Contact Number

Assistant Group Leader

First Name

Last Name

Mobile

Additional Contact Number

Activity Details

Location of Activity

Start Date

End Date

Location Classification (What classification of grounds is the activity being held on?)

Private Property

State Forest

National Park

Wilderness

Church Property

Other

Please specify location classification

Objective of Activity

Recreational

Pathfinder Class Requirement

Honour Requirement

Educational

Training

Other

Please specify objective of activity

Number of Children/Youth

Number of Adults

Youngest Participant

Oldest Participant

Do you require confirmation of public liability insurance? – By land manager or other (eg.State Forests, National Parks, etc)

Yes

If you need a certificate visit http://www.rms.org.au/covers/public-liability

Risk Assessment Completed

Yes

I agree to complete and submit a risk assessment.

Template Risk Assessments can be found at here.

Please complete your Risk Assessment and upload it below.

Please upload your Risk Assessment here

Choose File

Please upload your risk assessment here:

Choose File

Your Email