You must have JavaScript enabled to use this form. Select the item you wish to report - Select -AccidentIncidentNear Miss Accident Details State what happened Date of accident Time of accident Site of accident Athletics Activity Type - Select -Long JumpHammerHigh JumpTriple JumpDiscusJavelinShotPole VaultSprint Hurdles400m HurdlesSteeplechaseSprintsTrack Endurance ActivityWheelchair EventSeated ThrowFell Trail RunningRoad RunningPhysical Preparation TrainingWarmUp ActivityCross Country RunningOther accident_event_category - Select -PropertySlip Trip FallSporting InjuryStruck By ObjectOther Body Part Injured - Select -MouthButtocksFootTrunk DiscNo Physical InjuryChestUpper ArmLower LegHipMultiple TrunkToesVertebraeInternal OrgansWrist HandEyeAbdomen GroinWristMultiple Lower ExtremitiesNeck Multiple InjuryMultiple Head InjuryThumbSkullUnclassifiedUpper BackLumbarBody SystemsDiscHandLower ArmShoulderUpper LegAnkleArmKneeWhole Body Please select the most appropriate body part injured Type Of Injury - Select -BurnDislocationInflamationLoss of HearingDizzy FaintMental DisorderForeign BodyStrainElectric ShockNo Physical InjuryRuptureFractureLacerationCrushingMultiple InjuriesFreezingAsphyxiationHerniaSprainChestPainStrokeCarpal Tunnel SyndromeBruiseGrazeUnknownHead InjuryNoneAsthma AttackCardiac ArrestOther Nature of Injury Was First Aid given? Yes No Was the injured party taken from site of the accident to hospital? Yes No Injured Person Details Injured Person Name Age - None -Under 18Over 18 Injured person's Club Contact Address Post Code Phone Email Address Near miss or Incident Please state why you consider this to be a near miss State what happened Athletics Activity Type - Select -Long JumpHammerHigh JumpTriple JumpDiscusJavelinShotPole VaultSprint Hurdles400m HurdlesSteeplechaseSprintsTrack Endurance ActivityWheelchair EventSeated ThrowFell Trail RunningRoad RunningPhysical Preparation TrainingWarmUp ActivityCross Country RunningOther Athletics Event Meeting Title/Training Venue/Event Name/Club Name: Lead Person/Organiser Event - Select -CompetitionTrainingOther Date of incident Time of incident Site of incident Reporting Person Details Contact Name Contact Address Post Code Phone Number Email Address Your Role Status - Select -AthleteSpectatorOfficialWitnessOther I declare that the information provided is accurate. Leave this field blank