Incident Report

Club: Illawarra Ramblers Inc.

"*" indicates required fields

Reported by*
This can be the person affected, the leader or a participant who witnessed the incident
e.g. Mount Keira ring track
(if known)
Please enter a number from 1 to 5.
Type of activity*
Leader's name*
Name of injured person*
(if known)
DD slash MM slash YYYY
Time of incident
e.g. authorities or other agencies notified
Witness 1
Witness 2
e.g. attachments, photos
Drop files here or
Accepted file types: jpg, gif, png, pdf, Max. file size: 16 MB, Max. files: 3.