Event Staff Safety Declaration Form
Please complete the Event Staff Safety Declaration Form to confirm your readiness and commitment to safety at this event.
Full Name
*
First Name
Last Name
Role / Position at Event
*
Organization / Team Name
*
Event Name
*
Event Date
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Event Location / Venue
*
Emergency Contact Name and Phone Number
*
Safety Declaration Checklist
*
I confirm I am fit and able to perform my duties at this event.
I am aware of the event's emergency exits and procedures.
I agree to follow all instructions from event staff and supervisors.
I commit to reporting any hazards or incidents immediately.
Safety concerns, restrictions, or notes for the event
Signature / Acknowledgment
*
Submit Declaration
Submit Declaration
Should be Empty: