Student Safety Pledge Form

, who is enrolled in Technology Education

will as part of his/her lab experience, operate machines, providing that the parent or guardian gives written permission.

It is important that each student be given proper instruction, both in the use of the equipment and in correct safety procedures concerning it, before being allowed to operate it. The student must assume responsibility for following safe practices, and we therefore ask that the student subscribe to the following safety pledge.

1. I promise to follow all safety rules for the lab.

2. I promise never to use a machine without first having permission from the instructor.

3. I will not ask permission to use a particular machine unless I have been instructed in its use, and have made 100% on the safety test for that machine.

4. I will report any accident or injury to the teacher immediately,

Date Student Signature

I hereby give my consent to allow my son or daughter to operate all machines and equipment necessary in carrying out the requirements of the course in which he or she is enrolled.

Date Parents/Guardian Signature _________