Accident & Injury Report Form
SQUASH WALES ACCIDENT FORM
| Full Name of injured person:
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| Venue of accident:
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Location of accident:
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| Date of accident: | Name of individual/s who dealt with accident:
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| Nature of the accident:
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| Details leading up to the accident:
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| Details of events after the accident:
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| Details of First Aid treatment given:
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| Responsible Adult
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Signature:
Print Name:
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Date:
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| First Aider
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Signature:
Print Name:
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Date:
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| Venue/Site
co-ordinator |
Signature:
Print Name
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Date:
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