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The following is a Nativity Event Safety Form that must be completed and approved prior to an event being conducted.
Nativity Event Safety Form
OUTLINE OF EVENT
This form is for:
*
a one-off event
regular/multiple events
Please select one only.
*
Indicates required field
Name of event/s:
*
Date/s from:
*
Enter the date the event commences
Date to:
*
Enter the date the event concludes. If it is a one-day only event, write the date of the event again here.
Team leader/s:
*
Contact phone:
*
SITE INFORMATION
This section relates to the location where the event is to be held.
Site name:
*
Site contact number:
*
Complete this if applicable.
Site address:
*
If additional venues or locations will be used for the event described above, please list these below:
*
List the likely activities that will be conducted at these venues:
*
CONTACT INFORMATION
Main contact person
*
Phone number
*
Alternate contact person
*
Phone number
*
FIRST AID ARRANGEMENTS
First aid coordinator
*
Name
Level of training
*
Please list the names of additional helpers running the event. If they have first aid training, please indicate level.
*
Please use this chart, together with your team to work out the
risk level
of your risk management plan. You are planning how to manage any foreseeable risks or possible emergencies that may occur during your event.
Identified safety risk
*
Likelihood
*
Rare
Unlikely
Possible
Likely
Almost certain
Consequence
*
Insignificant
Minor
Moderate
Major
Servere
Risk level
*
Low
Medium
High
Very High
Extreme
Action plan
*
What we will do to reduce this risk to an acceptable level.
Emergency strategy
*
What we will do if this risk becomes a reality.
Identified safety risk
*
Identified safety risk
*
Identified safety risk
*
Identified safety risk
*
Identified safety risk
*
Likelihood
*
Rare
Unlikely
Possible
Likely
Almost certain
Likelihood
*
Rare
Unlikely
Possible
Likely
Almost certain
Likelihood
*
Rare
Unlikely
Possible
Likely
Almost certain
Likelihood
*
Rare
Unlikely
Possible
Likely
Almost certain
Likelihood
*
Rare
Unlikely
Possible
Likely
Almost certain
Consequence
*
Insignificant
Minor
Moderate
Major
Servere
Consequence
*
Insignificant
Minor
Moderate
Major
Servere
Consequence
*
Insignificant
Minor
Moderate
Major
Servere
Consequence
*
Insignificant
Minor
Moderate
Major
Servere
Consequence
*
Insignificant
Minor
Moderate
Major
Servere
Risk level
*
Low
Medium
High
Very High
Extreme
Risk level
*
Low
Medium
High
Very High
Extreme
Risk level
*
Low
Medium
High
Very High
Extreme
Risk level
*
Low
Medium
High
Very High
Extreme
Risk level
*
Low
Medium
High
Very High
Extreme
Action plan
*
What we will do to reduce this risk to an acceptable level.
Action plan
*
Action plan
*
Action plan
*
Action plan
*
Emergency strategy
*
What we will do if this risk becomes a reality.
Emergency strategy
*
Emergency strategy
*
Emergency strategy
*
Emergency strategy
*
EVENT PLANNING INFORMATION
How many people are likely to be involved in the event(s)?
*
Have you organised a safety briefing as part of your event
*
Yes
No
Is this activity appropriate for the age range of the intended participants?
*
Yes
No
Do you have enough help to run the event safely?
*
Yes
No
What is the ratio of helpers to participants?
*
Do you have an up-to-date first aid kit and know where it is?
*
Yes
No
Will driving vehicles occur as part of your event?
*
Yes
No
If yes, please confirm with safety team that drivers and vehicles are suitable for your event.
Please list any other relevant information about your event here:
*
SIGN OFF
Having considered the risks within this activity and determined an action plan to minimise those risks, I consider this to be an appropriately safe event to conduct.
Team Leader name
*
First
Last
Email
*
Date
*
Submit
Home
About
Us
Service Times
Calendar
Ministries
>
Children and Youth
>
Preschool
>
First Steps
Tunes 4 Tots
Primary
Intermediates
Youth
Families
Small Groups (Care Cells)
Women
Men
Senior Adults
>
Care
Prayer
Missions
Contact Us
How We Help
Courses
>
Healing Horticulture
The Marriage Course
Repair Cafe
Baptisms
Weddings
Funerals
Counselling
>
Bereavement Care
Personal Counselling
Blue Door
Giving
>
Serving
Financial
Venue Hire
Sermons
News
News and Events
Building Project
Bishop's Apology
Health & Safety