Emergency Response Plan Worksheet

Emergency Response Planning Worksheet

Lawrence University values the safety and security of all guests. It is the responsibility of every camp, conference or program director utilizing Lawrence facilities to have formal plans in place for ensuring the safety of all program participants and for dealing with emergencies including fire, severe weather, and when applicable, lost participants and lost swimmers. Established programs may already have comprehensive documents in place for Emergency Preparedness. If this is the case, these documents may be referenced in any of the sections below by indicating, "Separate document will be submitted." Documents should be emailed to events@lawrence.edu.

University guidelines will be provided to program directors once a contract has been finalized. Each conference/camp/program director is responsible for submitting a program-specific Emergency Response Plan, along with an alphabetized roster of staff & participants (and room assignments if applicable), to the Conference & Event Services Office at least 10 business days prior to the start of the program.

Name of Program *

Brief Description of the Program *

Include day or residential program, age range, number of minors and gender of participants.

Start Date/Check-in *

Year

Month

Day

First day someone from the group will be on campus.

End Date/Check-out *

Year

Month

Day

Last day someone participating in the group will be on campus.

Contact information of on-site individuals with primary responsibility
for the Program.

Primary Contact Name *

Title *

Mobile Phone *

Email Address *

Additional Contact Name *

Title *

Mobile Phone *

Email Address *

Who will have the most up to date roster of staff and participants? *

Who will have participant/staff health info., meds and the Medication & Treatment Log? *

Include name & contact info.

Do you have staff trained to perform rescue or medical duties in an emergency? If so, what training do they have? *

Where will you hold an emergency check-out? *

Who will account for all participants and staff? *

Include name & contact info.

Who do your participants contact in the event of an emergency? *

Who will be in charge of coordinating with any participants with special needs? *

If applicable, who will be responsible for collecting and returning keys to Conference & Event Services?

Who will be in charge of transporting participants who aren't picked us or don't have personal transporation? *

Where will your designated assembly area be in the event an evacuation is necessary? *

Who is responsible for taking roll call? *

Provide a summary of any Emergency Preparedness Training to be held with your staff, including any topics covered. *

Do you provide your staff with an emergency kit or any particular emergency equipment? If so, list specifics here. *

Who is in charge or reporting to campus or public safety? *

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