Fifth Grade 2015-16 SCIENCE SAFETY CONTRACT

Science is a vigorous, hands-on class. Many activities will require the use of sensitive equipment, as well as, various household items.
Safety is the first priority within our classroom lab. This Science Safety Contract is a list of rules that must be followed in science.
No science student will be allowed to participate in science activities until this contract has been signed by both the student and a
parent or guardian.
1. I will follow all instructions carefully, written and verbal, about the laboratory procedures given. Ask your teacher
questions if you do not understand the instructions.
2. Bring only your lab instructions, notebooks, and writing instruments to the work area.
3. Dress properly for the laboratory.
a. Roll long sleeves above the wrist.
b. Do not wear loose-fitting sleeves or bulky outerwear.
c. Tie back long hair.
d. Take off dangling jewelry.
4. I will not touch any equipment or supplies until instructed to do so by the teacher.
5. I will act responsibly at all times in the classroom. I understand that horseplay, jokes, and pranks are not appropriate in a
science classroom.
6. I will perform only those activities that have been authorized by the teacher. I will never do anything that is not called for
by the procedure. I understand that unauthorized experiments are forbidden.
7. I will keep my table and the area around it clean and neat. Return all equipment clean and in working order to the proper
storage area. Never open storage cabinets or enter the prep/storage room without permission from the teacher.
8. I will immediately notify the teacher of any emergency.
9. I will not take anything out of the classroom without permission from the teacher.
10. I will never eat, drink, or chew gum in the classroom unless instructed to do so by the teacher. I will not use classroom
equipment as containers for food or drink.
11. I will only handle living organisms when authorized to do so by the teacher.
a. Handle all animals with care and respect.
b. Open animal cages only with permission.
c. Never handle any animals when the teacher is out of the room.
d. Do not take animals out of the science room.
e. Do not tease or handle animals roughly.
f. Keep animals away from students faces.
g. Wear gloves when handling animals.
h. Report any animal bite or scratch to the teacher immediately.
12. Treat all preserved specimens and dissecting supplies with care and respect.
a. Do not remove preserved specimens from the science room.
b. Use scalpels, scissors, and other sharp instruments only as instructed.
c. Never cut any material towards you always cut away from your body.
13. Report any cut or scratch from sharp instruments to the teacher immediately. Keep hands away from face, eyes, and
mouth while using science materials or when working with either chemicals or animals. Wash your hands with soap and
water before leaving the science room.
14. I will wear my safety goggles whenever we are working with chemicals or heat. I understand that there are no
exceptions to this rule.
15. If chemicals splash in your eyes, use eyewash. Notify your teacher immediately of any spills.
16. Follow your teachers instructions to dispose of any waste materials generated in an experiment.
17. Use care with electricity.
a. Always make sure electrical cords are kept away from the edge of the table where people passing by can catch
them.
b. Always make sure that your hands are dry before you handle any electrical equipment.
c. Always use electrical equipment in a completely dry area.
18. Always carry a microscope with both hands. Hold the arm with one hand; place the other hand under the base.
19. Be careful with laboratory glassware.
a. Always check glassware before you use it. Never use glassware that is chipped or cracked. Show this glassware
to your teacher.
b. Never use your bare hands to clean up broken glassware.
c. Always be careful when carrying glassware to and from your work area.
20. Know where the exits are located and what to do in case of an emergency or fire drill.

Signature Page
Dear Student,
Created by AIS 5th Grade Science Teachers

Fifth Grade 2015-16 SCIENCE SAFETY CONTRACT

A quick safety review will be given orally at the start of each activity. You will be instructed in science
classroom safety, a safety quiz will be given, and the student / parent/ guardian safety contract must be signed
before participating in any hands-on science activity, no matter how simple the experiment.
I, ____________________, (student) understand and agree to follow all of the safety rules in this contract. I
understand that I must cooperate completely and obey these rules to make sure my fellow students, my teacher,
and I work and learn in a safe environment. I will also closely follow the oral and written instructions provided
by the instructor. I am aware that any violation of this safety contract that results in unsafe conduct in the
laboratory or misbehavior on my part will result in being removed from the classroom, or other appropriate
measures to maintain safety.
Student Signature ___________________________________

Date_________________

-----------------------------------------------------------------------------------------------------------------------------------Dear Parent or Guardian:

I am honored to have your student in science. I want to create and maintain a safe science
classroom/laboratory environment. Please be aware of the safety instructions your child will receive before
participating in any laboratory work. Please read the list of safety rules on page 1.
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 me. Your signature on this contract indicates that you have
read this Student Safety Contract, are aware of the measures taken to insure the safety of your child in the
science laboratory, and will instruct your child to uphold his/her agreement to follow these rules and procedures
in the laboratory.
Students who chose not to follow any rules and regulations of this Science Safety Contract will sit out
from science hands-on activities for two weeks. They will only observe or be placed back in the textbook to
read about what others are doing. I am very firm when it comes to the safety of each student, and when it
comes to interfering with someone elses learning. I do not give warnings when it comes to these two
important items.
I want to keep all the students, who I am blessed to teach, safe. Please understand the importance of
these rules. Even though the labs we will be conducting are simple, students could be hurt through horseplaying or not following the rules.
Parent/Guardian Signature:_______________________________Date:_____________________
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Important questions:
Each student may be using a sharp instrument (small knife/scissors, with adult supervision, in order to cut and
dissect different items during the year.
Do you feel your child can safely use a sharp instrument?
Yes or No
Do you feel your child can work around sharp instruments?
Yes or No
Does your child wear glasses or contact lenses?
Yes or No
Is your child color blind?
Yes or No
Have you spoken with your child about these Science Safety Contract requirements?
Yes or No
Does your child have any allergies?
Yes or No
If so, please list: ______________________________________________________________________
__________________________________________________________________________________________

Created by AIS 5th Grade Science Teachers