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Injury, Accident and Safety Report

Use this page to report an injury, accident, near miss or safety concern connected with South Galway Stormers.

Notice: Please complete this form as soon as possible following any injury, accident, or safety-related incident.

Incident Details

Date of Incident*

Time of Incident

Time

:HoursMinutes

Location of Incident*

First Name*

Last Name*

Role of Person Involved*

Player

Coach

Official

Spectator

Other

Description of the Event*

Include details of the activity taking place at the time and any equipment being used.

Nature of Injury*

First Aid Administered?*

Yes

No

Details of First Aid or Treatment

Witness Details

Action Taken to Prevent Recurrence*

Photos or Statements

Upload photos of hazards, damaged equipment, or witness statements.

Please upload images or documents only.

Does this incident involve a child-welfare or safeguarding concern?*

Yes

No

Unsure

Name of Person Reporting*

Email of Person Reporting*

South Galway Stormers Basketball Club

sgstormersbc@gmail.com

Proudly serving basketball in South Galway

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