icc logo

Inverness Canoe Club // Incident Report Form

Club Curach Inbhir Nis // Foirm Aithisg Tachartais

Inverness Canoe Club coaches/leaders should use this form to submit details of any incidents which occur on official club trips. Please submit one form per incident.

Coaches/leaders reporting incidents in this way need have no fear or concern about action being taken against them. The specific details of any incident reported will only be used if required in connection with an insurance claim and will be held in the strictest of confidence (in accordance with the Data Protection Act).

The purpose of the form is to ensure that reporting requirements are met and that in the unlikely event that a claim is made against a coach/leader, club member or the club itself, the insurers can act speedily to cover the claim. The non-reporting of this type of information could result in the SCA's insurers limiting cover or denying indemnity.

If those involved in an incident are also members of the SCA, they should also each complete the BCU's Incident Report Form and return it to the address stated at the foot of the form.

General details
Club name: Inverness Canoe Club Report date: 18 May 2012

Reporter's details
Your name: Your address:
Your phone no.: Your email:

Incident details
Incident date: Incident time:  :
 
Names of those involved and/or injured:
 
Contact details for those involved and/or injured:
 
Description of incident:
 
Details of any injuries:
 
Details of any actions taken:
 
Details of any first aid treatment:
 
Details of any emergency service involvement:
 
Details of any evacuation:
 
Details of any witnesses:
 

Outcome (as far as can be determined at time of report):

 
Additional information:

       
   
Design & Concept by RuralAccent | © 2010 Inverness Canoe Club. All Rights Reserved