Off-Campus Events/Travel

Please Fill This Form Out at least 10 Days Prior to Your Activity

Previously Completed a Risk Assessment for this Activity?

If you have completed a full Risk Assessment in the past for a similar Program, you can email the Risk Manager stating that you have done so and reference the past Assessment for the current/upcoming Program. However, if there are any major changes to be made to the previous Assessment, you will need to complete a new Assessment.

Email the Risk Manager

Off-Campus Events/Travel Risk Assessment

Name*
First Last
Phone
Email*
Date Activity Starts
MM slash DD slash YYYY
Date Activity Ends
MM slash DD slash YYYY
Detailed Description of All Activities*
Is this a Course Trip?
- Yes
- No
What is the Course Number?
Number of Participants*
EWU Faculty/Staff Students (18 & Over) Student (Less than 18) Non EWU Affiliated
If There are Minors, Have You Had Background Checks for all Trip Leaders?
- Yes
- No
Where are you Going?*
- Travel is Within Spokane County
- Travel Within Washington State
- Travel to Other USA Locations
- Area Experiencing Natural Disaster, Civil or Political Unrest
- Traveling to a Private Property
Check all that apply
Modes of Transportation
- University Vehicle
- Privately Owned Vehicle
- Rental Vehicle
- Commercial Carrier (ie., Planes, Train, or Bus)
- Privately Owned Aircraft or Boat
- Bicycle
Check all that apply
Identify Possible Risks or Hazards*
- There will be exposure to animals
- There will be exposure to insects or poisonous plants
- Activities require strenuous exertion
- Field conditions or activities are challenging (i.e., rough terrain, high crime area, epidemic, hazardous materials, using heavy machinery?)
- Traffic conditions in this area present special problems
- Crowds
- Remote location
- Alcohol
- Other
Check all that apply
Describe any Other Potential Risks or Hazards
Has a Near-by Medical Facility or Medical Provider Been Identified?
- Yes
- No
Will First Aid be Available on Site?
- Yes
- No
Things you plan to provide to prepare participants for this trip:
- Travel Safety Briefing
- Medical Care Info (What to do / where to go for health care)
- Risks (travel, weather, terrain, crowds, crime, etc)
- Behavior expectations (Student Conduct Code)
Check all that apply
What Are Your Plans if There is a Disciplinary Issue?
Will There be any Agreements or Contracts with Third Party Vendors? If so, Please Describe…
Do you understand that any participants who are prescribed an epinephrine auto-injector must bring it along for this trip?*
- Yes
- No

EWU Faculty/Staff	Students (18 & Over)	Student (Less than 18)	Non EWU Affiliated