Incident Report

Please fill the form to help us keep a safe environment and avoid future accident.

Date Field

Name of Person in Charge of the session

Name of injured person

Parent's/Guardian's Name if minor

Was the parent/Emergency person contacted, if so, for what reason?

Where the accident happened

Nature of the incident

Were any following contacted?

Police

Family

Ambulance

Discribe how the incident/accident happened

Give full details of the action during any first aid treatment and name first Aider(s)

What happened to the injured person follow the incident?

Attached images of the injury if possible and appropriate.

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