GBC Risk Assessment Form

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GBC Risk Management Form

IF YOU ARE FILLING OUT A FORM FOR WATER-SKIING CONTACT ME DIRECTLY dale@gladbap.org.au FOR ADDITIONAL RISK ASSESSMENT INFORMATION ABOUT THE SPECIFIC RISKS RELATING TO DIFFERENT TYPES OF SKIING (EG. SKIING, SINGLE SKI, KNEE BOARDING ETC).

* Indicates required question

Ministry *

BYG House

Boys' Brigade

Kids' Space

Girls Arise

Squeals on Wheels

Other:

Required

Activity *

Your answer

Date of activity *

If the risk assessment is for a regular activity, put "weekly" with the year, or "regularly" with the year

Your answer

Name of Person Completing Form *

Your answer

Key Risks *

Your answer

Specific Safety measures for risks

Enter any specific safety measures to minimise the key risks

Your answer

What safety measures are you putting in place before the planned activity *

Ensure appropriate leader/ participant ratio

Ensure first aid kit is available

Head count of children involved

Check the weather

Check all participants are reasonably attired and apply sunscreen

Give clear instructions regarding boundaries for activities and children's involvement

Give clear instructions regarding sunscreen, hats, appropriate clothing, water

Give clear instructions regarding swimming and emergency evacuation from the water

Choose appropriate time for the activities (not when participants are too tired)

Set out clear rules and explain these to all participants

Check for potential health hazards

Think of activities for non-participants

Talk to leaders about risks and how to deal with them

Tell participants where to go when they're hurt

Make sure participants know that they are going to get messed up and dirty

Check the equipment is in good working order

Choose a leader to be in charge in an emergency

Choose and specify a time limit

Organise a signal to end the activity in case of emergency

Drinking water available

Provide Shade

Other:

Required

What safety measures are you putting in place during the activity *

Reinforce sun care and reapply every hour

Ensure water is available and allow regular breaks for water

Clear instructions given on rules for activity and reinforce as the activity progresses

Observe children getting overly rough or silly in games and pull people aside/time out for participants not following rules

Leaders supervise the participants

Head count periodically to check that all participants are present

Monitor the safe use of equipment by participants during activity

Clear signals to leave/evacuate

Have a good and fair referee

Keep participants from being too competitive (shuffle teams)

Don't allow partcipants to wander off

Don't allow the game to go on for too long

Have regular breaks (every 20 mins) - ensure regular drinks of water

Provide adequate shade (non participants or batting team sitting down in shade etc)

Other:

Required

What safety measures are you putting in place after the activity *

Head count of children at end

Ensure all equipment and gear has left the appropriate area

Check for any injuries

Debrief (if necessary)

Clean up area

Clear instructons as to where the participants are to go next

Other:

Required

Safety Equipment

Signal device to get children's attention (whistle)

Sunscreen

Water

First Aid Kit

Shade Providers

Vinegar (for stingers)

Other:

Emergency Response

Stop Activity

Get First Aid officer

Assess extent of injury

Contact Ministry Co-ordinator

Call Ambulance (if needed)

Advise parent if participant requires more than just first aid

Occupy rest of group

Other:

Emergency Contacts

Most of the information shouldn't change

Ambulance 000

Location and phone for Gladstone GP Super Clinic, 216 Philip St. (07) 4978 1999

Phone number of CP Co-ordinator: Pastor Dale Lawrence; M:0498 548 244

Other:

email address for completed risk assessment *

This is the email address that you would like the risk assessment sent to

Your answer

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