CSUCI RM 3/2013
Academic Field Trip Site Assessment
This assessment is completed pursuant to CSU Executive Order 1062. The assessment is intended to identify and
mitigate reasonably foreseeable risks associated with field trips, and minimize the University’s liability exposure by
demonstrating and documenting sufficient knowledge of the academic field trip site prior to the arrival of C.I.
students and other field trip participants.
Field Trip Site: Assessment valid for academic year:
Field Trip Site Address/Location:
Course(s):
Field trip date(s):
Assessment completed by: Date: Onsite Visit: YES NO
Equipment/supplies to be provided by participant:
Equipment/supplies to be provided by field trip leader (faculty):
Physical activities to be undertaken include:
Risks inherent in this field trip include bodily injury due to:
Will there be any exposure to animals, insects or poisonous plants?
Are site conditions or activities challenging (i.e., rough terrain, weather hazards, high
crime urban area, exposure to hazardous substances, or involving the
use of heavy machinery)?
Has a near-by medical facility or medical provider been identified?
Is first aid available at the site or with the field trip leader?
Is an emergency plan for evacuation, rendezvous, and return from site in place?
Does the instructor have sufficient knowledge of the field trip site?
To further mitigate liability exposure participants should arrange their own transportation, and Release of Liability forms
shall be completed by all participants prior to embarking on the field trip.
This assessment form should remain on file in the academic department along with the instructional agenda and
corresponding Release of Liability Waivers. (Ref. EO 1062)
Release of Liability Waivers must be kept on file in the department for three years (Tech. Letter RM 2011-01).
