Volunteer Safety Framework

Volunteer Activity Attendance Record Template

For Official Use Only Page 1 of 4

This template can be used where volunteers are attending a DEWNR endorsed activity when there is no other attendance record available or being used

Activity/Project Name: ..................................................................................................................... …………………………………………………………………………………………………………………..

Activity Location: ...................................................................................................................................................................................................................................................................................

Date of Activity:

Staff/Activity team leader(s): ..........................................................................................................................................................................................................................................................

Volunteers please note: Any pre-existing health condition(s) which this activity may affect, will need to be communicated to the activity team leader by signing this form you will be covered by insurance and agree to abide by the DEWNR terms of participation on all volunteer activities and projects This form will be kept and filed securely by DEWNR.

Date Volunteer Name Emergency Contact Name &

Number. Start Time

Signature End

Time Total Worked

Hours

Volunteer Safety Framework

Volunteer Activity Attendance Record Template

For Official Use Only Page 2 of 4

1. RISK ASSESSMENT

A review of the on-site dynamic risk assessment indicates no new hazards or changes to site, activity or participating volunteers:

☐ YES ☐ NO If NO – risks assessment must be updated or new participants inducted prior to activity commencing (refer to Form 2). 2. INCIDENT REPORTING (for volunteer activity team leaders only in the absence of DEWNR staff being present

on-site) 

Were there any ‘notifiable incident’ (death, serious illness/injury, dangerous occurrence):

☐ YES ☐ NO

If YES contact DEWNR staff member/duty officer immediately. The WHS Act requires that so far is reasonably practicable, that the site where the incident occurred is not distributed until an inspector arrives at the site or any earlier time that an inspector directs. This includes any plant, substance, structure or thing associated with a notifiable incident. DEWNR staff are responsible to notify SafeWork SA of all notifiable incidents and to ensure site preservation.

Were there any incidents/near miss/hazards: ☐ YES ☐ NO

If YES – has the incident/near miss/hazards been reported using HIRM or to DEWNR staff:

☐ YES ☐ NO

If YES – reported to which DEWNR staff member: Name:…………………………………………………………..Date:

Details of incident/near miss/injury/hazard (what, where, when who): 3. ACTIVITY CLOSE OUT Total Number of volunteers involved: Total Number of volunteers hours: Final site departure check(s) done:

☐ YES ☐ NO Any other comments/observations on the day:

Volunteer Safety Framework

Volunteer Activity Attendance Record Template

For Official Use Only Page 3 of 4

Date Volunteer Name Emergency Contact Name &

Number. Start Time

Signature End

Time Total Worked

Hours

Volunteer Safety Framework

Volunteer Activity Attendance Record Template

For Official Use Only Page 4 of 4

Date Volunteer Name Emergency Contact Name &

Number. Start Time

Signature End

Time Total Worked

Hours