General information

    Name of coach / manager:


    Date of report completion:

    Time of report completion:


    Trainee information

    Trainee name:


    Course (Eg December start):



    Accident information

    Date of incident:

    Time of incident:

    Location of accident:

    Details of the accident:

    Are there any physical or behavioural signs from the injured person?

    Were there any witnesses? If so please list here.

    What was the outcome? Doctor visit / hospitalised / helicopter evacuation / etc.

    Have you contacted next of kin and what have you said?