Incidents

This form should be completed by the Welfare Officer, Attending Coach, or other Exec member who witnessed the incident. Players and Guardians also have the option to submit this form to highlight any issues or safeguarding concerns that occurred at an event which were not witnessed by any of the above listed members of the London Knights, this can be submitted anonymously if you are uncomfortable disclosing your identity.

We will publish all outcomes on our incident reports page. If you have any queries or would like to follow up on incident please contact us at welfare@londonknightsdodgeball.com.

*Only one form needs to be completed per incident, including in instances where multiple people have been effected.

Type of IncidentInjuryInjuryConductLoss / DamagesSafeguardingOther

Name of Person Involved in the Incident *

First

Last

Contact Details of Person Involved in the Incident

Location *

Date of Incident *

dd/mm/yyy

Person in Charge *

Name and/or Organisation running the event (person's name is only for London Knights events).

Details *

Describe in as much detail as possible what happened, who else was involved, were there any witnesses, etc.

What immediate actions were taken?

Was Anyone Contacted *

• Yes
• No

If Yes Who

Ambulance, Parent/Guardian, Venue Staff, etc.

Declaration *

• I Certify that all the above facts are a true and accurate record of the incident.

Electronic Signature

Type "anonymous" if you do not wish to disclose your name.

Submit