Science Safety Agreement

Name:_______________________________

Period:_______

I will:

1. Follow all written and oral instructions given by the teacher.
2. Read the lab procedures and instructions before the lab.
3. Ask questions or state concerns before beginning a lab procedure.
4. Always wear goggles (even if I have glasses) and an apron. 
5. Always come dressed appropriately for lab (closed toed shoes, long hair tied away from the face, clothes that will not interfere with procedure).
6. Know the location of the safety materials, and immediately inform my teacher of any hazards or injuries.
7. Refrain from eating, drinking, chewing gum, applying perfume/cologne, and applying cosmetics during lab exercises.
8. Refrain from reckless and inappropriate behavior such as splashing lab partners of startling other students.
9. Keep record of lab procedures and data.
10. Clean up after myself and leave the lab space as it was before I started class.
11. Write my own lab report that is independent and distinct from that of my lab partner’s report.
12. Turn off all electrical equipment and gas/Bunsen burners before leaving the lab area (especially in an emergency).

I understand that failure to comply could result in injuries to others or myself.  If I am not in compliance with the guidelines I understand that I will be penalized and may receive a referral.  I have read the guidelines and agree to follow them in lab activities. I have also read the syllabus and understand the policies.

Date:____________               Student signature:__________________________________

Date:____________               Parent signature:___________________________________

In the event of an emergency please contact:

Name:______________________________

Phone number:_______________________

________________________________________________________________________

Parents:  If you would like to be contacted via email for a conference or other reasons, please give your email address:________________________________________________

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