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Get AETC 410 2006-2024

PRECONDITIONS AGREED UPON DURING BRIEFING i.e. specific location special equipment medical screening HAZARDS OF THE ACTIVITY List them DATE YYYYMMDD APPROVED SIGNATURE OF MEMBER AETC FORM 410 20060701 PREVIOUS EDITION IS OBSOLETE.. DATE HIGH-RISK ACTIVITIES WORKSHEET I. INDIVIDUAL DATA INFORMATION To be filled in by the individual and sent to Commander GRADE/NAME Last First Middle Initial AGE UNIT/OFFICE SYMBOL DUTY PHONE LIST HIGH RISK ACTIVITIES Flying civilian aircraft hang gliding sky diving parasailing whitewater rafting motorcycle and auto racing scuba diving bungee jumping and other similar activities DATE OF LAST PARTICIPATION YYYYMMDD If applicable FREQUENCY OF PARTICIPATION WEEKLY MONTHLY SEASONAL OCCASIONAL IDENTIFY PREVIOUS EXPERIENCE IDENTIFY SPECIALIZED TRAINING REQUIRED/COMPLETED FOR THIS ACTIVITY LOCATION/AREA WHERE ACTIVITY WILL OCCUR i*e* business location name address phone number II. COMMANDER S REVIEW AND BRIEFING SECTION BRIEFING INSTRUCTIONS* Commanders should discuss training experience use of safety equipment rules and precautions with personnel participating in high-risk activities. This risk assessment is not intended to prohibit personnel from participating in high-risk activities but to ensure they are familiar with the hazards and injury potential of these activities. Commanders should ensure personnel wishing to participate in high-risk activities use appropriate safety measures. If commanders determine these personnel are inadequately trained or inexperienced and or a threat to safety and the mission exists they must prohibit these personnel from participating in the activity. However the commander s role in safety does not replace the individual s responsibility. The individual must exercise sound judgment and self-discipline and not put life limb or the performance of his or her Air Force duties in jeopardy. DATE HIGH-RISK ACTIVITIES WORKSHEET I. INDIVIDUAL DATA INFORMATION To be filled in by the individual and sent to Commander GRADE/NAME Last First Middle Initial AGE UNIT/OFFICE SYMBOL DUTY PHONE LIST HIGH RISK ACTIVITIES Flying civilian aircraft hang gliding sky diving parasailing whitewater rafting motorcycle and auto racing scuba diving bungee jumping and other similar activities DATE OF LAST PARTICIPATION YYYYMMDD If applicable FREQUENCY OF PARTICIPATION WEEKLY MONTHLY SEASONAL OCCASIONAL IDENTIFY PREVIOUS EXPERIENCE IDENTIFY SPECIALIZED TRAINING REQUIRED/COMPLETED FOR THIS ACTIVITY LOCATION/AREA WHERE ACTIVITY WILL OCCUR i*e* business location name address phone number II. COMMANDER S REVIEW AND BRIEFING SECTION BRIEFING INSTRUCTIONS* Commanders should discuss training experience use of safety equipment rules and precautions with personnel participating in high-risk activities. COMMANDER S REVIEW AND BRIEFING SECTION BRIEFING INSTRUCTIONS* Commanders should discuss training experience use of safety equipment rules and precautions with personnel participating in high-risk activities. This risk assessment is not intended to prohibit personnel from participating in high-risk activities but to ensure they are familiar with the hazards and injury potential of these activities. .

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