Site Sign In

Name *

First Name

Last Name

Phone *

(###)

###

####

Sign In Date *

MM

DD

YYYY

Sign In Time

Hour

Minute

Second

AM PM

I will wear the correct PPE at all times whilst working onsite *

Yes

I agree to report hazards, incidents or near-misses to Lux Productions as soon as practically possible *

Yes

I have read the specific JSA for the site/event and I understand what I need to do in an emergency *

Yes

I understand I need to secure the site at the end of the day or when I go to take a break *

Yes

NA

By submitting this induction I certify that I have read the event specific health and safety plan and agree to the site rules:* *

I accept this digital submission in replacement of my physical signature. All persons coming onto this site under Lux Productions shall read and understand the JSA - including all event specific health and safety requirements. Contractors, guests, vendors and members of the public signing this document take responsibility for their own safety and agree to follow Lux Productions' health and safety policies. Failure to do so will result in immediate removal from site. Where required to full time staff, Lux Productions will provide all appropriate personal protective equipment (PPE) - contractors and part-time employees are to provide their own PPE.

“I have read, understood, and agree to the procedure and controls documented and how to advise near misses and hazards.” I further agree and understand all risks and hazards relating to site and work