Please use this confidential form to report a health and safety event to Reading Athletic Club.

Please note: any safety event, however small, involving a javelin, discus or hammer before use or during a throw must be reported

Note: * means the field is required before the form can be completed

Date

Note date format is DD MM YYYY

YYYY

Reported by:

First Name

Last Name

Phone Number

What's Happened?

Is someone injured?

Yes

Injured Person:

First Name

Last Name

Extent of Injury:

Remedial Action Taken (if any):