On Site Risk Assessment Checklist

Heat: Temperature over 36 degrees
Rain: Any rain that would affect participation
Wind: Winds over 50km/h

Hazards:
On or near pathways, exits, such as debris, protrusions etc.

Activity Space:
Such as holes, cracks, debris (glass, syringes), etc.

First Aid:
Including first aid personnel, first aid kits, ice, etc.

Other factors:
Such as sun protection, participant behaviour, signs etc.

Actions
Safety Concern should be addressed to an acceptable level and recorded before the activity commences. Here are some examples of actions you might take...

Yes / Acceptable: If you are satisfied the conditions are safe to start the activity, please tick the YES column.

No / Action Required: If you find a safety concern please tick the NO column and record your actions in the space provided.

IMPORTANT NOTE: IF SAFETY CONCERNS CAN NOT BE ADDRESSED TO AN ACCEPTABLE LEVEL, THE CHECKLIST SHOULD NOT BE SIGNED AND ACTIVITY SHOULD NOT COMMENCE UNTIL CONDITIONS ARE ACCEPTABLE.

Date AND Time of Inspection

PLEASE TICK YES to indicate Acceptable Conditions.
PLEASE TICK NO to indicate Action Required.

Weather Conditions: In regard to participant safety, are the weather conditions satisfactory for activities to commence? *

Yes No

Activity Space: In regard to participant safety, is the venue surface satisfactory for the activity to commence? *

Yes No

Has all visible debris, that may affect participant's safety, been removed? *

Yes No

Facilities: In regard to safety, are the public areas (e.g. seating, walkways) free of visible hazards? *

Yes No

In regard to safety, are the public facilities (e.g. toilets, change rooms) free from visible hazards? *

Yes No

Are First Aid facilities (e.g. First Aid Kits, qualified personnel and ice) on site and accessible? *

Yes No

Are there shaded areas, sunscreen and clean drinking water available? *

Yes No

Other factors (please insert details of safety areas specific to your circumstance)

The following area/s (below) are satisfactory for the activity to commence? *

Yes No

Please provide details of actions taken to address your safety concerns: *

I. The above inspection (risk assessment checklist) was completed as per the above date and time.
II. All hazards, risks and safety concerns have been addressed to an acceptable level and recorded on this form
III. The activity space conditions are acceptable prior to the commencement of the activity.

I declare that after inquiry, the above declarations and statements are true and accurate. *

By ticking 'TRUE / ACCURATE' you are agreeing to the declarations statement. If NO is selected, this risk can be submitted, but the activity can not commence. TRUE / ACCURATE NO

Please print your name: *

Printing your name will serve as a digital signature as well as for identification.

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