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Dringhouses Scouts
Navigation Menu
Navigation Menu
Latest News
Vacancies
Join Us
Joining: Youth Members
Joining: Adult Volunteers
Members Area
Health and Wellbeing
Group Annual Reviews
Group Policies & Governance Documents
Information For Members
Information for Parent/ Adult Helpers
Group Events
Section Representatives
Member Support Fund
The Parent Portal
Parents Facebook Group
Event / Activity Refund Request
Uniform Exchange
Information for Adult Volunteers
Online Scout Manager
Compass
Training for Adult Volunteers
Appointment Review Form
Expense Claim Form
Accident Reporting Form
Near Miss Reporting Form
Fire Evacuation Drill Report
Minibus Receipt Submission
Bookings
Minibus Bookings
Shop
Contact Us
Search for...
Basket
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Accident Reporting Form
Please use this form to report all accidents, whether reportable to HQ or not.
Please submit this form with as much detail as possible to describe the nature of the injury and what led to it as well as any treatment given and by whom it was administered. We may also need to record the names of any witnesses.
Please enable JavaScript in your browser to complete this form.
Leader's Name
*
First
Last
Name of leader reporting the ./kaccident
Leader's Email Address
*
Enter your Dringhouses Scouts email address
About the Casualty
Please complete the following fields, a separate form will be required for each casualty
Name
*
First
Last
Please enter the name of the casualty
Date of Birth
*
Please enter the date of birth of the casualty
Address
*
Address Line 1
Address Line 2
City
State / Province / Region
Postal Code
— Select country —
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia (Plurinational State of)
Bonaire, Saint Eustatius and Saba
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cabo Verde
Cambodia
Cameroon
Canada
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Congo (Democratic Republic of the)
Cook Islands
Costa Rica
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Côte d'Ivoire
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Eswatini (Kingdom of)
Ethiopia
Falkland Islands (Malvinas)
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard Island and McDonald Islands
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran (Islamic Republic of)
Iraq
Ireland (Republic of)
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Korea (Democratic People's Republic of)
Korea (Republic of)
Kosovo
Kuwait
Kyrgyzstan
Lao People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macao
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia (Federated States of)
Moldova (Republic of)
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Macedonia (Republic of)
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine (State of)
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Romania
Russian Federation
Rwanda
Réunion
Saint Barthélemy
Saint Helena, Ascension and Tristan da Cunha
Saint Kitts and Nevis
Saint Lucia
Saint Martin (French part)
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten (Dutch part)
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia and the South Sandwich Islands
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen
Sweden
Switzerland
Syrian Arab Republic
Taiwan, Republic of China
Tajikistan
Tanzania (United Republic of)
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkmenistan
Turks and Caicos Islands
Tuvalu
Türkiye
Uganda
Ukraine
United Arab Emirates
United Kingdom of Great Britain and Northern Ireland
United States Minor Outlying Islands
United States of America
Uruguay
Uzbekistan
Vanuatu
Vatican City State
Venezuela (Bolivarian Republic of)
Vietnam
Virgin Islands (British)
Virgin Islands (U.S.)
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Åland Islands
Country
Please enter the address of the casualty
Age Group
*
Child/ Young Person (under 18)
Adult (over 18)
Please indicate if the casualty is a child or an adult
Section
*
Monday Squirrels
Tuesday Squirrels
Friday Squirrels
Monday Explorers
Tuesday Beavers
Tuesday Cubs
Tuesday Scouts
Wednesday Beavers
Wednesday Explorers
Thursday Cubs
Thursday Scouts
Friday Beavers
Friday Cubs
Friday Scouts
Casualties Section
Main Contact
*
Name of the main contact for the injured party, e.g. parents name
Main Contact's Phone Number
*
Phone number of the above named main contact
Main Contact's Email Address
*
Email address of the above named main contact
Role
Leader
Exec Member
Active Support
Occasional Helper
Member of the Public
Other
Role of the injured party
Phone Number
*
Phone number of the injured party
Email
*
Email address of the injured party
About the Incident
Please enter full details of what happened in the fields below
When
*
Date
Time
When did the incident occur?
Where
*
Please enter the location that the accident happened
What happened?
*
Please describe the incident, what happened?
Nature and location of any injuries
*
Please describe the type of injury and where is on the body as specifically as possible
Treatment given:
*
Please list in as much detail as possible the treatment that was given and by whom it was administered
Witness Details:
*
Please list the name and email address/ phone number of anyone who witnessed the incident
After the accident the person involved
*
Continued with the meeting/ event
Went home early
Went home as it was the end of the meeting/ activity
Went to Hospital
Went to their GP
Went to their Dentist
Went to another medical practitioner (please specify more details below)
More details
*
Was a bump on the head form issued?
*
No, not relevant
No
Yes, to the young person
Yes, given to the parent/ carer
Yes, given to the person that collected the young person
If a bump on the head form was not issued to the parent/ carer directly please ensure that they are contacted immediately to confirm the form was received
Please indicate all parties that were informed of the accident:
*
Nobody
Parent/ Carer in person
Parent/ Carer by phone, text or email
Group Scout Leader
Assistant Group Scout Leader
District Commissioner
HQ
999 was called
Doctor was called
Dentist was called
Note you don’t necessarily need to inform everyone on this list, it is useful to keep a record of who was contacted
Data Privacy Agreement
*
I consent to Dringhouses Scouts storing my submitted information so they can respond to my inquiry.
Please see the Group’s
data privacy notice
First Aid Equipment Used
*
Please list any items from the first aid kit which were used and need to be replaced. Enter none if no first aid supplies were used.
Email
Submit