Clwb Hoci Eirias - Incident form

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Please use this form to report any injuries or incidents relating to our Hockey activities in training sessions, tournaments or matches.

Type of incident *

Injury during a Juniors Training Session

Injury during a Seniors Training Session

Injury during a Juniors match

Injury during a Seniors match

Hockey Ball hit through or over the fence at Eirias Pitch during a training session (Junior or Senior)

Hockey Ball hit through or over the fence at Eirias Pitch during a match (Junior or Senior)

Other:

Date of the incident *

YYYY

Please give details of the incident
*

For injuries; nature of injury, part of the body injured, was injury caused by the ball, a stick or collision with another player, name of player(s) injured, age if under 18, protective equipment (shin guards, gumshield, helmet, gloves etc.) worn by injured person(s), first aid treatment given, was hospital treatment needed?

For balls through the fence; state which part of the pitch the ball went through such as Abergele Road or Eirias School for goal ends or carpark / dugouts for sides of the pitch and whether ball went through or over the fence.

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