Incident Reporting | London Welsh RFC

Please use this form to report player injuries, accidents and safeguarding concerns.

Date and Time of Incident

Day

Month

Year

Time

HoursMinutes

Type of Incident

Player's Name, Age & Date of Birth

Description of Incident / Injury

Initial Action Taken

Did the Player resume playing / training?

Yes

No

Advice given to the Player / Parent / Guardian

Paramedic services called?

Yes

No

Actions taken

First Aider / Coach Signature

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LWRFC Section Chairperson Signature

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I declare that the info I’ve provided is accurate and complete to the best of my knowledge.

LONDON WELSH RFC