Faculty of Engineering, Health, Science and the Environment

Field Work Participant Form

This form is to be completed by the Participant annually and submitted to if participating in multiple trips. If participating in a once off fieldwork activity, this form is to be completed and submitted to the Onsite Activity Leader at least TWO WEEKS prior to the trip. In the event of a solo participant undertaking fieldwork they are considered the Onsite Activity Leader.

Participant Name
Designation / CDU Staff CDU student Volunteer or other*
Supervisor Name
Supervisor phone number(s) / Business hours:
After Hours:

*includes all non-CDU participants. Volunteers must be approved by the Theme Leader/ Head of School / Director / PVC.

Please note that any participants travelling without prior written approval by the Head of School/Director/PVC are not covered by CDU insurance policy. Please ensure you make all participants aware of this.

In Case of Emergency - Person to contact (one is sufficient if two not possible):

Name:
Phone: / Name:
Phone:

Participant’s Declaration:

  1. The information that I have provided in this application is accurate and complete and I acknowledge that I have a responsibility to work safely in the field, taking reasonable care to protect my own health and safety, and that of any other participants and the public.
  2. I have disclosed to the Onsite Activity Leader any limitation imposed by my health that may affect my ability to participate safely in the field work activity. I have made arrangements to carry adequate supplies of my regular medication(s) (if applicable) as I am aware that the first aid provisions do not include medications. I will undertake any necessary treatment(s) or obtain vaccinations for any medical condition(s) that occur as a result of; or may be required for; this field work.
  3. I understand that it is my responsibility to ensure that I have been briefed sufficiently and completed all training advised on the field work activity and related emergency procedures and will comply with all procedures and directions provided by the Onsite Activity Leader and as outlined in the University and Faculty/School policies, manuals, procedures and codes of conduct relating to field work.
  4. OVERSEAS TRAVEL ONLY - I have also registered my travel on Smarttraveller and obtained the necessary approval for travelling overseas to countries with a DFAT Warning Level 3 and attached the approval memo to the CDU Movement Request for Official Travel.
  5. I understand that it is mandatory that the Onsite Activity Leader is solely responsible for making contact with the nominated CDU contact (as per Field Trip Plan) upon return to base. I understand that if contact is not made for any reason either throughout the trip, or upon return to base that the EHSE emergency procedure will be activated.
  6. If there is any variation to my fitness or medical conditions subsequent to this forms submission, they will be discussed with the relevant Onsite Activity Leader, and a new form submitted if required. If there are any variation to the type of activities participated in, I will discuss this with the relevant Onsite Activity Leader, and a new form submitted if required.

Signed: Approval for volunteer:

EHSE Field Work Movement FormPage 1