Templates
These templates were developed in consultation with WorkSafe NZ but are not the only way of documenting your safety system and won’t cover every aspect of your operation.
Use them in conjunction with other resources on this website to ensure you cover all safety topics and meet regulatory and industry good practice requirements.
WorkSafe NZ also has a generic guide to help you write effective health and safety documents. Read more.
Safety Management Plan
The SMP template and guidance document are designed to help operators meet the requirements of the Adventure Activities Regulations and the associated Safety Audit Standard.
Managing the risk of drugs and alcohol
The Adventure Activities Regulations require operators to include a drug and alcohol policy in their safety management plan. The policy must include:
- an assessment of level of risk posed by activities run by the operator
- an assessment of the level of risk posed by the nature of the operator’s workplace
- how the operator will manage these risks
- what processes the operator will adopt if a staff member is found to be under the influence or tested positive
Follow WorkSafe NZ’s guidance document to ensure your drug and alcohol management system is appropriate.
Standard Operating Procedures, Forms & Checklists
Forms and checklists are tools to help bring your safety system to life. They help guide your team through procedures and show that your systems are being used.
They usually appear as appendices to your safety management plan and standard operating procedures.
Adapt these templates for your operation.
Tips
- an appropriate person is responsible for filling out, using and reviewing forms and checklists
- clearly state any parameters, e.g. incident report forms must be completed within a certain time of the incident occurring
- a system that ensures they are current
- a location that is useful and appropriate, e.g. emergency response log with the back-up person or pre-trip checklists in the loading area
- clear guidelines for what to do with them once they are completed, i.e. where should they be kept and for how long
- their intended use, locations and associated staff responsibilities clearly stated in the safety management plan
- a copy located in the appendices of the safety management plan
Delete the example text in blue italics before using the templates!
- Activity report
- Drugs and Alcohol - an example of reasonable cause indicators and process
- Emergency Response Field Card
- Equipment Register and Inspection Calendar
- Equipment Log
- Equipment log multiple items per trip/activity
- Risk Register (template)
- Risk Register (example)
- Incident Report Form
- Internal Review Calendar and Checklist
- Job Role and Safety Responsibilities Form
- Job Role Competence Checklist
- Staff Induction Form
- Staff Information Form
- Staff Safety Meeting Agenda
- Statements of Competence - rationale and examples
- Trip Management Plan
- Trip report
Risk Disclosure Template
This Risk Disclosure Template has been developed by SupportAdventure as an example only—it was not created in consultation with WorkSafe New Zealand. We strongly suggest operators seek their own independent legal advice prior to using this template.