Camps and Conferences Form

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Welcome to the Environmental, Health and Safety Questionnaire for Science-Based Summer Camps & Conferences. Please complete the questionnaire and click submit. If detailed information is needed, someone from the Department of Environmental, Health and Safety will contact you. Thank you and we look forward to working with you during your time at Wake Forest University.

Camps and Conferences Lab Safety

Camp or Conference name(Required)

Organization(Required)

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Contact Name(Required)

First Last

Contact Email(Required)

Contact Mobile Phone(Required)

How many attendees are expected?

Will you require laboratory space?(Required)

Yes

How many days will the lab be needed?

Describe the curriculum and laboratory exercises:(Required)

Attach experiment procedures.

Max. file size: 23 MB.

Describe safety and health training program used to protect campers or attendees.(Required)

Attach any supporting documentation describing the safety and health training.

Max. file size: 23 MB.

Will any of the following be used?

Animal or human cells, tissue, organs, or blood

Chemicals

Sharps (needles, scalpels, razors)

If animal or human cells, tissue, organs, or blood are to be used, fully describe source, type and quantity.

Attach Safety Data Sheets for chemicals to be used.

Drop files here or

Max. file size: 23 MB.

If sharps are to be used, describe collection methods and safety precautions.

Describe types of Personal Protective Equipment (PPE) to be used, and decontamination or disposal method.

Will any of the following wastes be generated?(Required)

Biohazardous Waste from cells, tissues, organs or fluids

Chemical Waste

Sharps Waste

General Trash

If Biohazard Waste is to be generated, provide name, address and phone of waste collection company.(Required)

Camps and conferences are responsible for proper collection and disposal of Biohazard Waste generated at WFU.

Attach copy of contract for Biohazard Waste disposal.

Max. file size: 23 MB.

If chemical waste will be generated, describe type and approximate quantity.

Chemical waste must be collected in containers that are compatible with the waste. Incompatible chemicals may not be mixed in the same waste container. Contact WFU EHS (336-758-3427) for chemical waste collection and disposal requirements.

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