Zipline Safety Inspection Checklist Form
Complete this form to document the inspection of zipline equipment and operational readiness prior to use.
Inspector Name
*
First Name
Last Name
Inspection Date and Time
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Hour Minutes
AM
PM
AM/PM Option
Zipline Location
*
Weather Conditions
*
Please Select
Clear
Cloudy
Rainy
Windy
Other
Equipment & Line Condition
*
Please Select
Excellent
Good
Needs Maintenance
Unsafe – Do Not Operate
Operational Readiness
*
Please Select
Ready for Use
Not Ready – Issues Found
Inspection Checklist
*
Rows
Pass
Fail
N/A
Cables free from visible damage
1
2
3
Anchors secure and undamaged
4
5
6
Trolleys and pulleys operate smoothly
7
8
9
Harnesses and helmets inspected
10
11
12
Landing area clear and safe
13
14
15
Details of Any Issues Found
Additional Comments
Inspector Signature
*
Submit Inspection
Submit Inspection
Should be Empty: