Texas A&M University
Department of Biology Undergraduate Instructional
By signing this form, I verify that I read, understood and agreed to follow the safety regulations required
for this course as established by the Department of Biology and Texas A&M University.
I have located all
emergency equipment and now know how to use it.
I understand that I may be refused admittance to the
lab for failure to bring goggles, or for improper attire including open-toed shoes.
I agree not to bring food
or drink to the lab.
While in the laboratory, improper conduct or horseplay that may endanger myself or
others will not be tolerated, and I understand appropriate disciplinary action will be taken.
I realize that I
may be dismissed from this laboratory for failure to comply with the stated safety regulations.
Student Name (print): ___________________________________________________________________
Person(s) to be notified in the event of an accident or emergency:
Phone (Home): _________________________________Phone (Work)_____________________________
Any special medical conditions or other comments pertaining to lab safety):