The Our Savior Lutheran Science Department

School Year 2013/14 Laboratory Safety Contract

As a student in science class at Our Savior Lutheran School, I am aware of the potential risks to my classmates and myself during laboratory activities. In order to create a safe environment for all those involved in each science activity, I promise to do the following:

- I will conduct myself in a responsible manner at all times. I will never engage in horseplay or play practical jokes.

- I will carefully follow all instructions given by my teacher.

- I will never take chemicals, supplies, or equipment out of the laboratory without the knowledge and consent of my teacher.

- I will wear safety goggles whenever instructed to do so, and not take them off until the laboratory experiment is completed.

- I will wear a laboratory apron whenever instructed to do so, and keep it securely tied until the laboratory experiment is completed.

- I will wear protective gloves when instructed to do so.

- I will tie back my long hair and/or "tuck in" loose clothing to prevent them from getting into chemicals or flames.

- I will notify the teacher of any accident, injury, "close call", or lab equipment breakage no matter how trivial it may seem.

- I will clean my lab area, put all materials away as directed, and wash my hands at the end of each lab session.

I, ______have read and agree to follow the safety regulations set forth above. I do / don't wear contact lenses (circle one).

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Student's Signature Date

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Parent's Signature Date