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By completing this form I agree to be contacted by RLSS UK about the incident and I am happy to provide you with my details as below.
1. Details of the person involved in the accident
RLSS UK Society Number (if held)
2. Details of the person filling in the report - If you are the person above you can leave this section blank
Your Phone Number
Your RLSS UK Society Number (if held)
3. Please select one of the below
The accident occurred during:
A RLSS UK Branch session/ eventA RLSS UK Club session/ eventWhilst I was operating in my own capacity as an individual RLSS UK member on a voluntary or self-employed basis (e.g. delivering training outside branch/ club sessions; providing self-employed lifeguard services at a private pool party).
If you have selected Branch above, please provide the RLSS UK Branch name.
If you have selected Club above, please provide the Club name and Club society number.
4. Description of accident
Date of accident
Time of accident
Place where accident occured
Please provide a brief summary of the accident (for example, details of how the accident occurred with cause if known; details of any injury suffered; details of any treatment provided).
Details of witnesses (including name(s) and contact details).