Scottish Rowing Incident Report Form

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Please complete this online form to report any accident, collision or capsize, especially those involving injury to persons or damage to equipment. When completed the form will be forwarded to the Board Member responsible for Sport Governance and to the Scottish Rowing Safety Officer.

These reports are confidential, indeed they are covered by the Data Protection Act. It is possible that the Scottish Rowing Safety Officer may contact you to offer assistance. The information that you provide may also be used to produce anonymised advice to others.

The information you provide within this form will be kept by Scottish Rowing and may be shared with it's insurance agent if there is a claim made against the incident.

Name of Reporting Person *

Email of Reporting Person *

Role of Reporting Person *

Date report made *

YYYY

Evening phone number of reporting person *

What clubs or third parties were involved in the incident? *

What was the time (24 hour clock) and date of the incident? *

Where did the incident occur? *

Please give a full description of the incident. this should include weather and water conditions. *

List any injuries, by whom, who treated them and where. Also list any damage sustained by boat(s) or to property. *

Add any further comments or additional information you think could be useful - eg list of witnesses with addresses etc. *

What further actions have been, or will be, implemented to avoid a repetition of the incident? *

Do you have any documents about the incident eg drawings/diagrams/photographs? You may be asked to email them to the SR Safety officer as part of any investigation so please keep them safe. *

Yes

n/a

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