Accident Reporting

Report an accident or incident (near-miss)

The form below is designed to capture basic information about minor accidents or incidents that occur during a club activity.

As club members or participants we are individually responsible for our own safety and the safety of fellow runners.

Any club member can complete and submit a report, but ideally the form should be completed by:

Run Leaders/coaches aware that an accident (or near-miss) occurred in their group;

OR

Members directly involved in an accident (or who witness a near-miss incident) during a club session.

IMPORTANT!

Serious incidents must be reported at the earliest opportunity via the UKA website report form.

Note, the form require contact details of both the injured party and the reporting person.

Use of this Form

Please use this form to report minor injuries or incidents that occurred on a club run. If the injury or incident is more serious then it must be reported to the UKA via the form on their website. (Note, a more serious injury is one where emergency services were called, or where the injured runner is unable to walk back to the start of the run.)
Privacy
Your submitted form will be sent to the club Welfare Officers only (*prototype/test forms are also sent to chairs*). In some cases, the club may need to contact you to seek further details. Our Privacy Policy describes how we process your data. https://lymmrunners.org.uk/privacy-policy/

Your Name

First

Last

How can we contact you if we require further information?

Date of incident

Approximate Time

Name of Run Leader / Coach

Run Group

Accident or Incident Location

What happened?

Action Taken

Attached file (optional)File Upload