Accident Notification Form

If a child, young person, leader or anyone else sustains an injury whilst participating in a BB organised activity or event, the accident must be recorded in the Company/Church accident book with details of the injury, how it was sustained, and any first aid treatment given.

If the person requires professional medical attention (visit to GP, A&E, Minor Injuries Unit etc) either at the time of the accident or at any time as a result of the accident, then this Accident Notification Form MUST be completed and submitted. This is important as BBHQ has a duty to report these accidents to the Brigade Insurers.

If you have any questions please email support@boys-brigade.org.uk or phone 0300 303 4454.

Company Details

Company Name *

Details of Captain/Correspondent

First Name *

Last Name *

Address Line 1 *

Address Line 2

Town *

Postcode *

Phone Number *

Email Address *

Details of Person Suffering Injury

The person is a: *

Child or young person

Leader

Other

First Name *

Last Name *

Address Line 1 *

Address Line 2

Town *

Postcode *

Where the person who has suffered an injury is a child or young person, please enter details of their parent/carer:

Parent/Carer's First Name *

Parent/Carer's Last Name *

Phone Number *

Email Address *

Accident Details

Date * +

Time *

Place/Location *

Details of accident *

Details of injury *

Details of any treatment given at time of accident *

Details of any aftercare since the accident happened *

Details of any reflections - what could have been done differently? *

Action Plan - What will be done differently next time? *

Details of Witness

First Name *

Last Name *

Address Line 1 *

Address Line 2

Town *

Postcode *

Supervision

Was the activity in which the accident occurred supervised? *

Yes

Please enter details name(s) and address(es) of those supervising *

Accidents on Camps/Holidays

Did the accident occur on a camp or holiday? *

Yes

Name of leader holding a valid Holiday Leadership Certificate *

Leader Registration Number *

Phone Number *

Email Address *

Confirmation

Confirmation *

I confirm that the above is an accurate record of the accident

This Accident Notification will be sent to BB Headquarters, who will be in touch if further information is required. All communications will normally be channeled through the Captain/Correspondent.