Incident Report Form
Form for reporting incidents to Commercial Rowing Club
Email *
Name and role of Person completing this form *
Date of incident *
MM
/
DD
/
YYYY
Time of incident *
Time
:
Name(s) of person(s) involved in the incident *
Description of the incident 
(
State whether you were on the correct side of the river.

Were you overtaking?

Which part of the river / lake?

Was there a Commercial Coach on the bank or slip supervising you?

State your experience level, e.g. single sculling for 3 years.

Name of the boat/scull involved?

Equipment damage?

Did anyone go into the water?

Was the rescue launch launched?

Injuries to any part of body?

How did you get home? )

*

Witnesses

[mention which club they belong to]
*

Description of expected follow-up actions to be taken:

[State if the damaged boat should be taken out of service, e.g. hole in hull needs to be repaired]

*
A copy of your responses will be emailed to .
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