I, _________________________________ ,

hereby certify that on this day of

__________________________

I have successfully completed a review of safety procedures for the science classroom and I have passed a comprehensive safety exam. The following is a list of some of the procedures that I intend to uphold at all times.

• I will follow the safety guidelines of my teacher.

• I will keep my work area neat and free of unnecessary papers, books, and materials. I will keep my clothing and hair neat and out of the way, and I will wear a safety apron and/or gloves if necessary.

• I know the location of all safety equipment (such as the fire extinguisher and first-aid kit) and of the nearest telephone.

• I must wear safety goggles when handling chemicals, working with flame, or performing any other activity that might cause harm to my eyes.

• I will not use chemicals, heat, electricity, or sharp objects until my teacher instructs me to do so, and then I will follow my instructor’s directions carefully.

• I will be especially careful when using glassware. When heating glassware, I will make sure that it is made of heat-resistant material, and I will never use cracked or chipped glassware.

• I will wash my hands immediately after handling hazardous materials. I will clean up all work areas before I leave the laboratory, put away all equipment and supplies, and turn off all water faucets, gas outlets, burners, and electric hot plates.

Having understood and agreed to the above and all other safety precautions presented to me in this class, I am hereby ready to practice safety in the science classroom from this day forward.

Teacher’s signature

________________________________

Parent’s/guardian’s signature

________________________________