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Wilfrid Laurier University Students' Union 103 Darling Street, Brantford, ON, N3T 2K8 Tel: 519.756.8228, Ext. 5827 Fax: 519.758.9218 Web: www.wlusu.com/brantford Student Event Risk Management Form The Student Event Risk Management Form will be reviewed by the Brantford Operations Manager, Executive Vice President: Brantford, Associate Vice President: Activities and the Campus Clubs Coordinator to assess the level of risk associated with the event. If the level of risk is deemed acceptable then the event will be approved. You will be notified immediately if there are any issues or questions surrounding the event. If you are required to take additional action steps before the event can be approved, you will be notified and must verify that these action steps have been taken before your event can be approved. Events that are not approved cannot be carried out under any circumstances. All forms must be submitted to the Campus Clubs Coordinator a minimum of 3 WEEKS BEFORE the scheduled event*** Part A: Notice of Event Information Club Information Club Name: ______________________________________________________________ Contact Person 1: _________________________________________________________ Phone number: _____________________________________________________ Email: _____________________________________________________________ Contact Person 2: _________________________________________________________ Phone number: _____________________________________________________ Email: _____________________________________________________________ Event Information Title of the Event: ________________________________________________________ Primary Event Organizer: __________________________________________________ Contact number during event: ________________________________________ Date(s): _________________________________________________________________ Start time of event: _____________________ End time of event: ________________ Location of event: ________________________________________________________ Expected number of participants: __________________ Capacity of venue: _____________________ Description of event: ______________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ (This information may be publicized around campus so be precise with the information provided) Wilfrid Laurier University Students' Union 103 Darling Street, Brantford, ON, N3T 2K8 Tel: 519.756.8228, Ext. 5827 Fax: 519.758.9218 Web: www.wlusu.com/brantford Part B – Risk Assessment The purpose of this part is to: - Identify hazards and associated risks - Examine risk management techniques – either to prevent losses from happening or if unavoidable to reduce the frequency or severity - Select and implement techniques such as exposure avoidance, monitoring and improving the event as needed - Protect both the participant and the organizers 1. ALCOHOL INVOLVED? YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES YES YES YES YES YES YES YES YES NO NO NO NO NO NO NO NO NO YES NO NO If NO, skip to Section 2 Served by bartenders / venue? Name of venue: ___________________________________________________ Bartenders / venue management are “SmartServe” trained and are aware of their responsibility not to over serve or serve to minors Will the entrance / ticket cost include alcohol? If so, how much alcohol is included in the ticket price? __________________ Non-drinking volunteers (trained in either SmartServe, CPR and / or First Aid) designated to monitor attendees? Number of non-drinking volunteers present at the event? ________________ Will attendees bring their Health card (MSI, AID Student Health Plan, etc)? Will attendees bring government issued photo ID (drivers license, passport, etc)? Will All-age events have a wristband policy in effect? (Persons under 19 not permitted alcohol) Will security be informed of this event? (Security must be informed of any event on campus involving alcohol) Other: ___________________________________________________________________ __________________________________________________________________ 2. TRAVEL INVOLVED? YES NO YES NO YES YES NO If NO, skip to Section 3 Will group transportation be arranged? Rent cars / vans (insurance included in rental fee)? Name of company: __________________________________________________ Rent bus (insurance included in rental fee)? Name of company: __________________________________________________ Driving personal vehicle? (Must have a minimum of $1 million insurance) Travel arrangements are made for attendees with special needs (if necessary) Arrival / departure times known by all attendees? Do you have a contingency plan for persons missing return transportation? Will alcoholic beverages be permitted on the bus and / or rental van? Will intoxicated individuals be permitted to board the bus upon departure from WLU? Will attendees bring health card, identification and passport (as required?) Out-of-province / country? Out-of-province events: Does each student have adequate out-of-province health coverage? Out-of-country events: International students will pick up requisite forms from the International Centre (ex. ‘status letter’ and ensure their study permit is valid and up to date) Wilfrid Laurier University Students' Union 103 Darling Street, Brantford, ON, N3T 2K8 Tel: 519.756.8228, Ext. 5827 Fax: 519.758.9218 Web: www.wlusu.com/brantford YES NO YES NO Will there be a designated bus/van/car monitor on/in each bus/van/car who will not consume alcohol during the event/trip? Name of bus monitor: _______________________________________________ Other: ___________________________________________________________________ __________________________________________________________________ 3. PHYSICAL ACTIVITY / PERSONAL SAFETY RISK INVOLVED? If NO, skip to Section 4 YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES YES YES YES YES YES YES NO NO NO NO NO NO NO NO Moderate physical activity (ex. dancing, skating, running, etc) Activity: ___________________________________________________________ High physical activity (ex. ice hockey, skiing, paintball, rock climbing, etc) Activity: ___________________________________________________________ Equipment involving a degree of risk (ex. hot tubs, tampolines, major audio, etc) Name of equipment: ________________________________________________ Personal safety issues (ex. walking after dark, soliciting, working with ‘at risk’ persons, etc.) Potential issue: _____________________________________________________ Will the Primary Event Organizer bring St. Johns Ambulance approved first-aid kits? Will there be volunteers (trained in either CPR or First Aid) designated to monitor attendees? How many volunteers will there be? ___________________________________ Will attendees bring health card (MSI, AIG Student Health Plan, etc)? Will crowd control measures be put in place? In case of emergency, have arrangements been made for evacuation of students with disabilities? Will security be aware of your event and any special circumstances (including minors’ attendance?) Are organizers aware of pertinent information regarding nearest hospital and means for transport (location / phone number?) Other: ___________________________________________________________________ __________________________________________________________________ 4. COMMUNITY RELATIONS (ON & OFF CAMPUS) RISK INVOLVED? If NO, skip this section YES YES NO Will there be amplified music / speeches? Adherence to noise by-laws? Are you hosting the activity in a residential neighbourhood? Letter of notice sent to neighbours and surrounding businesses? Clean up crew has been designated? Venue staff will clean up? Other: ___________________________________________________________________ __________________________________________________________________ Wilfrid Laurier University Students' Union 103 Darling Street, Brantford, ON, N3T 2K8 Tel: 519.756.8228, Ext. 5827 Fax: 519.758.9218 Web: www.wlusu.com/brantford Part B: Primary Event Organizer Contract I _____________________________________________ (print name) hereby agree to act as the Primary Event Organizer on ___________________________________ (date) for the ________________________________________________ (name of organization)’s _____________________________________________________ (event). I am fully aware that: 1. I will be responsible for organizing the event. 2. I will ensure that the planning of the event complies with risk management procedures and alcohol policy. 3. I will ensure that the rules / procedures for the event are posted for all participants. 4. I will ensure that every event monitor is aware of their responsibilities. 5. In the event of an incident (illness, death, injury, criminal misconduct, etc) will complete a detailed Student Event Incident Report and submit a copy to the Campus Clubs Coordinator within one working day of the incident. 6. I will ensure the event will not compromise the dignity or general well being of participants. 7. I am responsible to ensure that all advertising will be consistent with the information I submit on the Student Event Risk Management form. 8. I will return the event venue to the original state that I received it in. 9. I am accountable to the President of my Club and/or the Wilfrid Laurier University Students’ Union, Campus Clubs and ultimately, Wilfrid Laurier University. I hereby acknowledge that If I break the Alcohol Policy or the Risk Management procedures I will be in violation of the Wilfrid Laurier University Students Union Campus Club Policies and will jeopardize the ratification of my society. I AGREE TO UPHOLD ALL THE REQUIREMENTS OF THE PRIMARY EVENT ORGANIZER AND AGREE NOT TO CONSUME ANY ALCOHOL ON THE DAY OF THE EVENT UNTIL THE EVENT ENDS AND ALL THE PARTICIPANTS HAVE SAFELY DISPERSED. Name of Applicant:________________ Signature:_________________________ Date: ___________ Position in organization: _________________________________________________________________ Student number: ________________________________________________________________________ Local address: __________________________________________________________________________ Local phone number: ____________________________________________________________________ Email: _________________________________________________________________________________ PART D: REVIEW OF EVENT All events that have an element of risk require the review of WLUSU. Brantford Operations Manager approval: _________________________________________________ Associate Vice President: Activities approval: ______________________________________________ Executive Vice President: Brantford approval: _____________________________________________ Campus Clubs Coordinator approval: ____________________________________________________ Wilfrid Laurier University Students' Union 103 Darling Street, Brantford, ON, N3T 2K8 Tel: 519.756.8228, Ext. 5827 Fax: 519.758.9218 Web: www.wlusu.com/brantford Primary Event Organizer: _________________________________________________________________ Club: __________________________________________________________________________________ Event name: ____________________________________________________________________________ Date: __________________________________________________________________________________ FOR ADMINISTRATIVE PURPOSES ONLY: One copy goes to the sponsoring organization’s Primary Event Organizer, one copy goes to the Campus Clubs Coordinator, to be kept by authority for seven years. Review Comments: ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ Primary Event Organizer signature: __________________________________________ Date: ___________________________________________________________________ Reviewed and signed by: AVP: Activities: _____________________________________ Date: ________________ Brantford Operations Manager: ________________________ Date: ________________ Old info from Off Campus Events form: (Should we merge this information with the SMUSA stuff?) Wilfrid Laurier University Students' Union 103 Darling Street, Brantford, ON, N3T 2K8 Tel: 519.756.8228, Ext. 5827 Fax: 519.758.9218 Web: www.wlusu.com/brantford Regulations Regarding Off-Campus Events The aim of the Students’ Union is to protect the individual student from conduct which might endanger his/her University career. At the same time, the prime consideration is to preserve the reputation and integrity of the University and the student body as a whole. While the Student’s Union is concerned primarily with the conduct of Laurier students and the prevention of property damage, it is important to recognize that the repercussions of events relating to alcohol apply to the University community as a whole. The following information is designed to regulate the activities of the Laurier campus community at any University or Students’ Union sponsored off-campus event in order to minimize any liability and maximize the safety of those participants in said events. General Guidelines 1. Students’ Union or Wilfrid Laurier University sponsored and/or endorsed off-campus activities must be registered with the Students’ Union Brantford Operations Manager and EVP: Brantford twenty-one (21) days prior to the event. 2. Registration of each off-campus activity is required prior to advertising the activity. All advertising on or off campus must be approved and stamped by the Brantford Operations Manager and EVP: Brantford’s offices. 3. It will be the responsibility of each individual participating in the event to accept the authority of the Event Leader and ensure that his/her own behaviour is consistent with that outlined in the WLU Student Code of Conduct. 4. Tickets for off-campus activities shall bear the following: Ticket holders are bound by the WLU Alcoholic Beverages 5. 6. Policy. Tickets must be approved by the Brantford Operations Manager and EVP: Brantford prior to their distribution on or off campus. If it is felt that a student has not abided by the foregoing regulations, he/she shall be referred to the Student Conduct Board. Problems which may arise with faculty, staff, or other personnel of Wilfrid Laurier University with respect to the Campus Alcohol Policy will be handled by the Office of the President. Transportation Guidelines 7. For every twenty-five (25) people travelling to or from an event in a Student’s Union or Wilfrid Laurier University 8. 9. sponsored vehicle, there must be one (1) person recognized as the Bus Leader. It is the responsibility of the Bus Leader to ensure that student behaviour is consistent with that outlined in the WLU Student Handbook. The consumption of alcoholic beverages is NOT permitted in any Student’s Union or Wilfrid Laurier University sponsored vehicle. Procedures for loading and unloading people from these vehicles must be submitted in writing and approved by the Brantford Operations Manager and EVP: Brantford prior to the event. I hereby commit to ensuring that the rules and regulations will be adhered to throughout the duration of my event. Add excerpt from alcohol policy to the bottom of this. Add the point about committee members not allowed to drink at event.
