Slackline Accident and Incident Report Form

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Thanks for taking the time to fill out a report with the International Slackline Association. We will publish some of these accident reports as a learning resource for the community and to gather data from the collection of many reports.

The first page asks for the basic information. Please fill all of this out. If you are willing, we'd also like to have more detailed information which can be added on the second page. Full narratives, analysis, and suggestions for other slackliners are greatly appreciated.

The person filling out this form should be familiar with the circumstances of the incident - either the person(s) involved or a rescuer involved in the incident. Please provide contact information so we can follow up with questions about the incident. At that time we will confirm which names (if any) may be used in a published report.

Reports submitted here will be used for safety analysis, compilation of data to identify common occurrences, and may be published in part or in full as part of either ISA or member association documents. If you would prefer your report is not published, please check the box at the end.

Created on 24-08-2015, Version v1.2, Modified 04-08-2016 (SI)

To fill out this form in English, go here:
http://SAIR.slacklineinternational.org

Um das Formular auf Deutsch auszufüllen, bitte hier klicken:
http://SAIRDE.slacklineinternational.org

Pour remplir ce formulaire en français, aller ici:
http://SAIRFR.slacklineinternational.org

Para preencher este formulário em Português ida aqui:
http://SAIRPR.slacklineinternational.org

Para rellenar este formulario en español vaya aquí:
http://SAIRSP.slacklineinternational.org

Name

(ex. John Smith. Please no pseudonyms or aliases. Names will not be publicly shared without permission and are for internal contact purposes only.)

Nationality

Email address

We will only use this to contact you in reference to this form

Your Role in the Incident

(Were you the person injured, a member of the party, a rescuer?)

Location of Incident (Country)

Location of Incident (Detail)

(Please provide Latitude/Longitude or a map point from either Google Maps or www.slackmap.com.)

Date of Incident

(Feel free to report old incidents. If exact date is unknown, select an approximate date.)

YYYY

Type of Slackline Involved

Basic Slackline (<30m long, <1m high)

Trickline

Longline

Rodeoline

Waterline

Highline

Other:

Type of Incident

(You may check more than one)

Failure (Bolt or anchor failure)

Failure (Gear failure)

Failure (Abrasion of soft materials)

Failure (Webbing break without apparent abrasion)

Near Miss (Gear malfunction without failure)

Rigging Error

Injury (Without equipment failure)

Injury (Due to falling from slackline)

Injury (Due to failure)

Injury (During rigging)

Injury (Accessing or exiting line)

Injury (Spectator or passerby injured)

Free Solo Fall

Other:

Required

Type of Injury

(You may check more than one)

Death

Abrasion

Laceration (Cut)

Fracture (Broken bone)

Dislocation (Joint injury)

Sprain (Joint injury)

Concussion (Head impact)

Spinal Injury (Backbone or neck)

Other Internal Injury

Heat Storke

Hypothermia (Too cold)

Frostbite (Frozen skin, fingers, toes, etc.)

Unknown

No Injury

Other:

Narrative Description of Incident

(Use as much space as needed to tell the complete story of the accident, including standing tensions on the line and other rigging details. Please be specific and include events that led to accident, group's familiarity with area, skill level, objectives, route, hazard evaluation, weather, etc.)

Can we publish this report?

(Names and personal details can be removed and you will be contacted before publishing.)

Yes

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