Incident Report Form

This form should be completed as soon as possible after an incident involving injury or property damage, or after a near miss.

Return 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.

If you have any questions or there’s a serious incident, please call the Delivery Team: 020 3961

3180 (Mon-Fri 9am-5pm).

In case of emergency, please dial 999.

# Area, Group or Partner Details

![](https://www.chelmerandblackwater-ramblers.org.uk/administrator/cache/preview/1d05e2ba8fd5f1bdcf6e94256f15284e.jpg)

Name of Group or Wellbeing Walks Partner

Name of Area

Activity or event (for example group walk, path clearance activity, AGM)

Date of activity

Number of participants

# Person leading the activity

(For example, the walk leader)

Name

Role

Membership number (if applicable)

Email address

Contact phone number

# Incident

Location, date and time

What happened and what action was taken?

# Person injured or affected by the incident

Name

Date of birth (or approximate age)

Are they a Ramblers member (Yes/No)

Membership number (if applicable)

Email address

Contact phone number

Details of the injury, the treatment and the current condition (if applicable).

Details of the damage to third party property (if applicable).

# Witness

If there is more than one witness, please list the others in the next section.

Name

Membership number (if applicable)

Email address

Contact phone number

# Additional information

For example, more details about the incident, extra witnesses, how likely is a claim.

# Your details

Name

Date

Role

Membership number (if applicable)

Please email completed forms to [incidents@ramblers.org.uk](mailto:incidents@ramblers.org.uk)

Privacy Policy:

_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._