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REQUEST FOR ACTIVITY RISK ASSESSMENT

Date Filed:

Requesting Office / Organization: Unit:


Contact/Point Person:
Email Address:
Immediate Superior:
Email Address:
Person in charge of activity risk management/safety protocols:

Activity Name: Activity Date/Period:


Nature of Activity: ( ) Co-curricular ( ) Extracurricular Venue:

Number of Participants (including the organizers):

Groups/organizations that are part of this activity (Internal and External):

Objectives / Description of Activity (explain the flow of the activity):

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