Earth Science Program
Faculties of Science and Social Science
Emergency Contact Form
Please note that this information is gathered under the authority of the Freedom of Information and Protection of Privacy
Act to inform field trip/school participants of hazards associated with such activities and to provide the University with an
acknowledgment from participants that they have been so informed. It also provides current emergency contact
information for participants. If you have any questions about the collection or use of this information, contact the FOIP
Coordinator for the Earth Science Program at 220-8626.
Please print in block letters
Name of field participant:___________________________________________________
Location of excursion/field school:___________________________________________
Date of excursion/field school:_______________________________________________
Name of Emergency Contact:________________________________________________
Phone number of Emergency Contact:_________________________________________
Your relationship to Emergency Contact:_______________________________________
EASC Emergency Contact Form 27 Apr 07