Incident Report Form

 

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Glasgow Rowing Club

(Est .1983)


Incident Report Form

Please complete this form to report any serious incident involving injury to persons or serious damage to equipment.


Your details
Name
Role at the club
Address
Phone Home
Other
Email
Incident details
What clubs or third parties were involved?
Types of boat involved 8+ / 4+ / 4- / 4x / 2- / 2x / 1x / Training 2x+ / Training 1x8+4+4-4x2-2x1xTraining 2xTraining 1x
Were the boats:The boats were:

What was the time and date of the incident?
Where did the incident occur?

Please give a full description of the incident; this should include weather, water, stream and tide conditions if relevant.

Please include or attach any additional details eg drawings/diagrams/photographs if these will enhance your description.


Signed Date
Email

To be completed by a GRC Committee member:

List any injuries sustained; who treated them and where:

Also list any damage sustained by boat(s) or to property:

Add or attach any further comments or additional information you think could be useful, eg list of witnesses with addresses etc.

What further actions have been or will be implemented to avoid repetition of incident? (use a separate sheet if necessary):

Signed Position held Date