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 |