Accident Reporting Form
Please use this form to report any accidents.

Thornbury Running Club must report any accidents to England Athletics and we need your help please to collect the information that is required. The form below and the data requested is based on the UKA 'Accident Reporting Form'.

Thank you for your help and for dealing with the accident.
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Email *
Name of Person Reporting Accident: *
Injured Person Name *
Please state what happened: *
Date of Accident: *
MM
/
DD
/
YYYY
Time of Accident: *
Time
:
Location / Site of Accident - please state where the accident happened (please include Post Code or What3Words location if known): *
Athletics Activity Type: *
Accident Category: *
Body Part Injured - Please identify the part(s) of the body injured in the accident: *
Type of Injury - please describe the type / nature of injury sustained e.g. bruise, graze, cut, fracture etc.: *
Was First Aid given?: *
Was the injured party taken from the site of the accident to hospital?: *
Anything you would recommend that could have prevented this accident or would prevent similar accidents in the future?
Thank you for reporting this accident. We may need to ask for more information when we report to EA. We will get in contact if we do. If you have any questions please contact the Club's H&S Officer on: hands@thornburyrunningclub.co.uk
A copy of your responses will be emailed to the address you provided.
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