_BRHS Science Lab Safety Contract by msb21215


									                     BRHS Science Lab Safety Contract
I, _________________________________________ (PRINT student’s name) have read the
BRHS Lab Safety Information sheet and agree to follow all safety rules. I realize that I must
obey these rules to ensure the safety of myself, my fellow students and my instructor. I will
cooperate to the fullest extent with my instructor and fellow students to maintain a safe lab
environment. I will closely follow all verbal and written instructions. I understand that if I am
unsure of the proper actions to take, it is my responsibility to seek guidance from the instructor. I
understand that performing unauthorized activities in the lab is a violation of lab safety
guidelines. I understand that any violation of safety guidelines, any unsafe conduct in the
laboratory, or any misbehavior on my part, may result in being permanently barred from
laboratory activities, receiving a failing grade, and receiving disciplinary actions.

Signature (student) _________________________________ Date __________________

Dear Parent or Guardian:

The BRHS Science Department wants you to be informed of our efforts to maintain a safe
science classroom/laboratory environment. With the cooperation of instructors, parents, and
students, a safety instruction program can eliminate, prevent, and correct possible hazards.

You should be aware of the safety instructions your son/daughter will receive before engaging in
any laboratory work. No student will be permitted to perform laboratory activities unless this
contract is signed by both the student and parent/guardian and is on file with the teacher.
Students will receive a grade of zero for any labs missed due to failure to return this signed
safety contract.

Your signature on this contract indicates that you have read this Student Safety Contract
and the BRHS Lab Safety Information sheet. You are aware of the measures taken to
ensure the safety of your son/daughter in the science laboratory, and will instruct your
son/daughter to uphold his/her agreement to follow these rules and procedures in the

If my child has a medical condition (including allergies) that could interfere with
laboratory participation or result in the need for emergency medical attention, I will
explain below:

Signature (parent) ____________________________________ Date _______

Daytime phone ________________________ Convenient hours ________________

Evening phone _____________________ Convenient hours _______________

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