Department of Music Conrad Prebys Music Center Manager's Performance Report

Manager's Event Report for Conrad Prebys Music Center.
To be completed at the end of each performance. Make sure to read through the whole form.

Event Title
[NEW] EVENT CODE
Event Date Event Date / MM / DD YYYY
Event - Scheduled Start Time Event - Scheduled Start Time : HH MM AM/PM
Manager Report

Provide your name, time in, and time out for your work call.
Example: John Smith 1200pm to 430pm, 500pm to 1000pm
Name of Manager submitting this form Name of Manager submitting this form First Last
Manager Name(s) / Times in & out
Manager's Email
Performance
Start Time Start Time : HH MM AM/PM
End Time End Time : HH MM AM/PM
Total Performance Length (hours and minutes)
Attendance (Number / House Count)
[NEW QUESTION] Was there a Reception

[NEW QUESTION] Was there a Reception Yes No
Please list any other notes or observations regarding this performance / residency.
Crew Report

Provide names, time in and time out for their work call.
Example:
John Smith 600pm to 1000pm
Jane Doe 600pm to 930pm
Crew Names/Times
SAFETY
Please report any safety concerns or issues here.
Please report all injuries and accidents to your supervisor - immediately.
Read Carefully

***WHAT TO DO IF YOU (OR A CREW MEMBER) ARE INJURED ON THE JOB***
https://blink.ucsd.edu/safety/occupational/reporting.html

#1 - Come to a safe stopping point.
#2 - Report the incident to your Event Manager, ASAP.
#3 - Seek medical attention, if needed.

You will be asked to complete the following:
Employees: https://blink.ucsd.edu/safety/occupational/reporting.html
- This report is to be completed by UCSD employees when an occupational (work-related) illness or incident occurs. Submittal of an Occupational Incident Report is not filing a claim for workers' compensation benefits.
- The UCSD Workers' Compensation Office will provide the employee with a California State Workers' Compensation Claim Form (DWC-1), if the work-related injury incident requires medical treatment beyond first aid or lost work days prescribed by a physician. Submittal of a completed DWC-1 claim form to the UCSD Workers' Compensation office activates a workers' compensation claim file.
- If the entire Occupational Incident Report (Employee page and Supervisor page) cannot be completed at the time of initial submittal, complete as many fields as possible. The information with * below is required for initial submittal.
- If the employee is unable to complete an Occupational Incident Report, the supervisor must report the Incident on their behalf.
- If you have any questions, please call your Workers' Compensation representative at: (858) 534-4785 or 822-2979.

Supervisors: https://blink.ucsd.edu/safety/occupational/reporting.html
Supervisor of injured UC San Diego employee must complete and submit this report to the Workers' Compensation Office in conjunction with either of the two reporting options utilized by the injured employee.
- Option A: Employee reported incident via online Employee Occupational Incident Report, or
- Option B: Employee reported incident via a reporting line: (877) 6UC-RPRT (877) 682-7778.

Incident Report for Students and Visitors:
https://blink.ucsd.edu/safety/occupational/reporting.html
INCIDENT REPORT
Report a work-related injury, illness, or hazardous material exposure
https://blink.ucsd.edu/safety/occupational/reporting.html
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Department of Music Conrad Prebys Music Center Manager's Performance Report

Department of Music Conrad Prebys Music Center Manager's Performance Report

Manager Report

Performance

Crew Report

SAFETY

Read Carefully