{"id":"6ad724d3cf7123de287d49a3","title":"Incident Report Form Word","path":"information/10-9-26-dates-for-your-diary-for-details-seec-b-news/incident-report-form-word","contentMarkdown":"Incident Report Form\n\nThis form should be completed as soon as possible after an incident involving injury or property damage, or after a near miss.\n\nReturn the completed form to [incidents@ramblers.org.uk](mailto:incidents@ramblers.org.uk) within 10 days of the incident, attaching any relevant supplementary information. We’ll let you know when we get it and copy it to your coordinator, or area/ group secretary for their information.\n\nIf you have any questions or there’s a serious incident, please call the Delivery Team: 020 3961\n\n3180 (Mon-Fri 9am-5pm).\n\nIn case of emergency, please dial 999.\n\n# Area, Group or Partner Details\n\n![](https://www.chelmerandblackwater-ramblers.org.uk/administrator/cache/preview/1d05e2ba8fd5f1bdcf6e94256f15284e.jpg)\n\nName of Group or Wellbeing Walks Partner\n\nName of Area\n\nActivity or event (for example group walk, path clearance activity, AGM)\n\nDate of activity\n\nNumber of participants\n\n# Person leading the activity\n\n(For example, the walk leader)\n\nName\n\nRole\n\nMembership number (if applicable)\n\nEmail address\n\nContact phone number\n\n# Incident\n\nLocation, date and time\n\nWhat happened and what action was taken?\n\n# Person injured or affected by the incident\n\nName\n\nDate of birth (or approximate age)\n\nAre they a Ramblers member (Yes/No)\n\nMembership number (if applicable)\n\nEmail address\n\nContact phone number\n\nDetails of the injury, the treatment and the current condition (if applicable).\n\nDetails of the damage to third party property (if applicable).\n\n# Witness\n\nIf there is more than one witness, please list the others in the next section.\n\nName\n\nMembership number (if applicable)\n\nEmail address\n\nContact phone number\n\n# Additional information\n\nFor example, more details about the incident, extra witnesses, how likely is a claim.\n\n# Your details\n\nName\n\nDate\n\nRole\n\nMembership number (if applicable)\n\nPlease email completed forms to [incidents@ramblers.org.uk](mailto:incidents@ramblers.org.uk)\n\nPrivacy Policy:\n\n_Sensitive personal data may be collected as part of any accident reporting on a group walk or other organised event. This information may be shared with our insurance company in line with our legal and insurance obligations. When sensitive personal information is collected, we will take extra care to ensure your privacy rights are protected. Our full Privacy Policy can be found on the Ramblers website._","contentHtml":"<p>Incident Report Form</p>\n<p>This form should be completed as soon as possible after an incident involving injury or property damage, or after a near miss.</p>\n<p>Return the completed form to <a href=\"mailto:incidents@ramblers.org.uk\">incidents@ramblers.org.uk</a> within 10 days of the incident, attaching any relevant supplementary information. We’ll let you know when we get it and copy it to your coordinator, or area/ group secretary for their information.</p>\n<p>If you have any questions or there’s a serious incident, please call the Delivery Team: 020 3961</p>\n<p>3180 (Mon-Fri 9am-5pm).</p>\n<p>In case of emergency, please dial 999.</p>\n<h1>Area, Group or Partner Details</h1>\n<p><img src=\"https://www.chelmerandblackwater-ramblers.org.uk/administrator/cache/preview/1d05e2ba8fd5f1bdcf6e94256f15284e.jpg\" alt=\"\"></p>\n<p>Name of Group or Wellbeing Walks Partner</p>\n<p>Name of Area</p>\n<p>Activity or event (for example group walk, path clearance activity, AGM)</p>\n<p>Date of activity</p>\n<p>Number of participants</p>\n<h1>Person leading the activity</h1>\n<p>(For example, the walk leader)</p>\n<p>Name</p>\n<p>Role</p>\n<p>Membership number (if applicable)</p>\n<p>Email address</p>\n<p>Contact phone number</p>\n<h1>Incident</h1>\n<p>Location, date and time</p>\n<p>What happened and what action was taken?</p>\n<h1>Person injured or affected by the incident</h1>\n<p>Name</p>\n<p>Date of birth (or approximate age)</p>\n<p>Are they a Ramblers member (Yes/No)</p>\n<p>Membership number (if applicable)</p>\n<p>Email address</p>\n<p>Contact phone number</p>\n<p>Details of the injury, the treatment and the current condition (if applicable).</p>\n<p>Details of the damage to third party property (if applicable).</p>\n<h1>Witness</h1>\n<p>If there is more than one witness, please list the others in the next section.</p>\n<p>Name</p>\n<p>Membership number (if applicable)</p>\n<p>Email address</p>\n<p>Contact phone number</p>\n<h1>Additional information</h1>\n<p>For example, more details about the incident, extra witnesses, how likely is a claim.</p>\n<h1>Your details</h1>\n<p>Name</p>\n<p>Date</p>\n<p>Role</p>\n<p>Membership number (if applicable)</p>\n<p>Please email completed forms to <a href=\"mailto:incidents@ramblers.org.uk\">incidents@ramblers.org.uk</a></p>\n<p>Privacy Policy:</p>\n<p><em>Sensitive personal data may be collected as part of any accident reporting on a group walk or other organised event. This information may be shared with our insurance company in line with our legal and insurance obligations. When sensitive personal information is collected, we will take extra care to ensure your privacy rights are protected. Our full Privacy Policy can be found on the Ramblers website.</em></p>\n"}