Accident Report Form | Urban Runner — Barefoot & Minimalist Running Group

👤 Your Details

First name *

Last name *

Contact number (optional — in case we need to follow up)

📍 Incident Details

Date of incident *

Approximate time

Session *

Track Night Clayhall Park Other

📋 What Happened

Describe what happened *

Type of incident *

Body part affected *

🩹 Severity & Response

How would you describe the severity? *

Minor I'm okay — no treatment was needed

Moderate First aid was given at the time

Serious Emergency services were called / hospitalisation required

Was first aid given at the time?

Yes No

Did you seek further medical attention?

Yes No

👥 Witnesses (optional)

Names of anyone who witnessed the incident

Separate multiple names with a comma.

📝 Additional Notes (optional)

Anything else you'd like to add?

ACCIDENT REPORT