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Accident Report Form
Please use this from to report any accident which occurs at Manvers Waterfront Boat Club. Please give as much information as possible - this will help us to investigate and put into place any actions required to keep everyone at the club safe. Please fill in a separate form for each person involved in the accident.
Details about the person who had the accident
*
Indicates required field
Name of person who had the accident
*
Name of person who had the accident
Contact Number for person who had the accident
*
Contact number of person who had the accident
Email address for person who had the accident
*
Email address of the person who had the accident
Address of person who had the accident
*
Address of the person who had the accident
Details about the person completing this report
Name of person reporting the accident
*
Name of person reporting the accident
Contact Number for person reporting the accident
*
Contact number of the person reporting the accident
Email address for person reporting the accident
*
Email address of the person reporting the accident
Address of person reporting the accident
*
Address of the person reporting the accident
About the accident
Time That The Accident Occurred
*
Time of accident
Date of Accident
*
Date of Accident
Where The Accident Occurred
*
Location where the accident took place
How The Accident Took Place
*
How the accident took place - include the cause if known
Details of Any Injuries & First Aid Administered
*
Details of any injuries to the person who had the accident
Submit
Home
About
About MWBC
Our Partners
Contact
What's On?
Activities
Paddlesport
Windsurfing & Sailing
Dragon Boating
Open Water Swimming
Running
Triathlon
Model Boating
Angling
>
Angling Rules
Membership
Cafe
Facility Hire
Room Hire
Events 2020
Volunteering
Safeguarding
The Commitee
Downloads
Near Miss/Hazard Reporting Form
Accident Reporting Form
Signed-Off Paddler Request Form
Manvers Lake Activities