WHS F067 English Language Centre Low Risk Excursion
This form must be used by anyone seeking approval for ELC Low Risk Excursions. The Organiser and the staff member who is Supervising and will be part of the excursion must complete this form.
Excursion Type (Tick appropriate box)Armidale Pine Forest / Armidale Sport & Rec Centre / Armidale Bowling Club
New England Camels / Education & Folk Museums / Town Tour
Scavenger Hunt (Armidale) / Local School Visit / Airport Pickups
Excursion Details
Name of person organising the excursion
Organiser contact number
Name of person supervising the excursion
Supervisorcontact number
Group Name
Size of group
Address of excursion
Contact number of facility
Type of activities to be undertaken / Date: / Dept: / Rtn:
Any procedures or site information list here and attach.
Any medical information attach to document
Transportation Details (Tick appropriate box’s)
University Vehicle / Public Transport / Private Transport
Car / Bus / 4WD
Aeroplane / Train
Drivers Name / License Number / Type of License / Comment
Name and signature of students travelling and by signing accept that they will take directions and instruction from the above mentioned staff. NB: This section is not applicable if the participants have already filled out the Excursion Declaration Form.
Name / SignatureAttached forms/Booking numbers
1 / Travel Booking completed / Yes/No2 / Motor Vehicle requisition / Yes/No
3
Acceptance from Supervisor:
I understand the size of the group including any medical conditions of those coming with me
Name: / Signature: / Date:Records Storage Instructions:
This completed form must be recorded in TRIM Container A16/3832 utilising a TRIM license in your School/Business Unit. The naming convention must include the name of the form. Only the HR Team is able to view records in this container.