Outdoor Adventure Risk Assessment Form
Please complete this form to identify, assess, and acknowledge the risks associated with your planned outdoor adventure activity.
Participant Full Name
*
First Name
Last Name
Contact Email Address
*
example@example.com
Contact Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Adventure Activity Name
*
Date of Activity
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Location of Activity (Trail, Park, Area, etc.)
*
Estimated Number of Participants
*
Risk Identification and Assessment
*
Rows
Potential Risk
Likelihood (1=Low, 5=High)
Impact (1=Low, 5=High)
Weather-related incidents
1
2
3
4
5
1
2
3
4
5
Slips, trips, and falls
1
2
3
4
5
1
2
3
4
5
Wildlife encounters
1
2
3
4
5
1
2
3
4
5
Equipment failure
1
2
3
4
5
1
2
3
4
5
Medical emergencies
1
2
3
4
5
1
2
3
4
5
What control measures or precautions will be implemented for identified risks?
*
Are emergency contacts and procedures in place for this activity?
*
Yes
No
Please rate your preparedness for this activity (1 = Not prepared, 5 = Fully prepared)
*
Not prepared
1
2
3
4
Fully prepared
5
1 is Not prepared, 5 is Fully prepared
Participant Signature (required for risk acknowledgment)
*
Submit Assessment
Submit Assessment
Should be Empty: