Accident forms

Accident/ Incident Report Form

This document can be used to record details of an accident/injury that occurred during a club activity.

Remember to be discrete with information recorded and abide by UK General Data Protection Regulation (GDPR)

Name of person:

(Enter name of affected person)

Home address

(of affected person, including postcode)

Contact details

(enter contact details of affected person)

Date and time of incident

Venue where incident occurred

Exact location of incident

Primary person dealing with incident

Others involved in dealing with incident

Full description of incident

Cause of Incident:

Injury Sustained (if any)

Initial Treatment (if any)

Any follow up actions

(taken by reporting person, e.g. logged with venue, informed parents, sent to hospital, how and with whom)

Person completing this report

Date of report