Report an accident

Name of person reporting the accident *

First

Last

E-mail of person reporting the accident *

Name of injured person *

First

Last

Address of injured person

Date and time of the accident *

Nature of incident/injury and extent of injury *

Give details of how and precisely where the incident took place. Describe what activity was taking place. *

Give full details of action taken during any first aid treatment and thename(s) of first-aider(s) *

Were any of the following contacted?

• Parents/carers
• Police
• Ambulance
• Fire bigade

What happened to the injured person following the incident/accident?e.g., carried on with session, went home, went to hospital etc. *

Name

Submit