Fillable Outdoor Plan And Risk Assess Form (Southern Utah University)

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Outdoor Plan And Risk Assess Form (Southern Utah University)

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www.suu.edu/siel/outdoor/
435-586-1983
OEC Trip Plan
Leaders Names:
Email: Phone #:
Trip Purpose:
Trip Location:
Date and Time Leaving:
Location Leaving From: Location Returning To:
Participants and their emergency contacts: Will add as participants join my group
Name of Participant
Emergency Contact (&
relationship)
Emergency Contact Phone
#
Leadership (who will be the leader? What skills, knowledge and fitness level does the leader
need to be successful?):
Trip Itinerary (where will you be each day?)
DATE
Start and End
Times
Starting Place
Ending Place
Notes (miles, need
to knows)
Weather Report (what is the expected weather?):
Maps I will need:
Permits (what permits do I need?):
Clothing and equipment (please customize these lists to fit your needs):
Food and water (what is your basic food and water plan?):
Accommodations (beyond camping/backpacking do you need a campground or hotel?):
Transportation (how will you get to your destination? How will you return?):
Communication devices (what emergency devices will you have?):
Participant Considerations (what skills, knowledge, and fitness level do the participants need to
be successful?):
Risk Analysis: Key factors - there can be others unexpected!
Environmental Factor Hazards
reduce the risk)
Human Factor Hazards
reduce the risk)
Safety B
riefing: Please write a script for an initial safety briefing for your trip which conveys the
hazards and mitigations you have identified in the above analysis.
-Keep Cool
-Assess the situation
-Create a safe scene for participants
-Provide appropriate first aid
-Collect needed information
-Make phone calls; Emergency services first then SUU Police—then call Briget Eastep
-Please do not speak to the media
-If an incident requires you to contact an individual’s emergency contact be compassionate and
caring…avoid comments placing blame or admitting fault.
SUU Emergency Phone List:
OEC Director
SUU Police
Briget Eastep
Dispatch
(435) 704-4239
(435) 586-1911
- Fill out Incident Report form: http://www.suu.edu/ad/facilities/pdf/Incident.pdf
Notes:
Emergency Information
Local Assistance:
Nearest Search and Rescue Unit:
Phone #:
Notes:
Land Management Agency:
Address:
Phone #:
Additional Emergency Contacts:
Address:
Phone:
Nearest Lodging in case of emergency:
Emergency Response Reminders
REMEMBER:
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Outdoor Plan And Risk Assess Form (Southern Utah University)

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Completed 24 July 2020

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