Outdoor Activities Club Auckland TRIPSHEET FORM C
Activity venue: ...................................................................................... Date: ..........................................................
Signing of this sheet confirms that: ..................................................................................... (Insert Leaders Name)
Is volunteering to lead this activity and will take all due care but no responsibility.
· You agree to abide by the leaders instructions, including staying with the group at all times.
· You are carrying the appropriate equipment
.· You have sufficient clothing, food and drink
.· You have informed the leader of any health conditions you may have that could impact on the group’s enjoyment. · You heed all the hazardous conditions that are listed on that back of this form.
· You the undersigned are totally responsible for your own safety.
No | NAME | Phone ** | Member Y/N | VAX Y/N | No | NAME | Phone ** | Member Y/N | VAX Y/N |
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| 21 |
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10 |
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| 25 |
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11 |
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| 26 |
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12 |
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| 27 |
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13 |
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| 28 |
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14 |
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| 29 |
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15 |
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| 30 |
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** = contact for family member or friend VAX Y/N tick when leader sights certificate
IN CASE OF EMERGENCY CONTACT………………………………………………………………………………………Phone………………………
This activity may have various hazards and hazardous situations; a general list of these is on the reverse side of this sheet
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