Technical Delegate Accident Report Form

Snowsport England

Technical Delegate Accident Report Form

In the event of an accident at a competition which requires an individual to be evacuated from the course, the TD must complete this report form and submit it along with the TD Report in the Results Package. If a copy of the official accident report of the professional rescue or first aid team is available, that report should be submitted in addition to this TD report.
TD Name
Competition
Location / Date
Organiser / Discipline
Course Name
Description of location of course
including references to slope, terrain, gradient, course/matting conditions, racer clothing, and safety protection:
(Please attach sketch)
Weather conditions / Time of day
Name of accident victim / Reg No
Competitor Coach Official Other
Address of victim
Telephone / Age
Reported or suspected injuries:
Describe first aid and evacuation::
Was the injured person taken to hospital? If so, which?
Evident cause(s) of accident/injury:
Attempted Recovery from error
Avoiding obstacle in course
Snow conditions off course
Avoiding official in course
Visibility
Collision with an official in course
Binding release/Equipment failure
Collision with a spectator
Inability to handle technical difficulty in course
Other causes or contributing factors in your opinion:
Narrative description of accident:
First Witness:
Name: / Age:
Address: / Tel no:
Witness account of incident (who, where, what happened):
(attach additional sheets if necessary)
Additional Witness:
Name: / Age:
Address: / Tel no:
Witness account of incident (who, where, what happened):
(attach additional sheets if necessary)
Additional Witness:
Name: / Age:
Address: / Tel no:
Witness account of incident (who, where, what happened):
(attach additional sheets if necessary)
Additional Witness:
Name: / Age:
Address: / Tel no:
Witness account of incident (who, where, what happened):
(attach additional sheets if necessary)
Is there a video-tape, film of photo record of the incident?Yes No
If yes, where may the record(s) be found, who is the contact person(s) and who has access?
List the Key race personnel involved:
Chief of Race: / Tel (H):
Address: / Tel (W):
Referee: / Tel (H):
Address: / Tel (W):
Others (note position):
Tel:
Tel:
Tel:
Tel:
Technical Delegate’s Description and Commentary:
Please use this space to provide any additional comments on the accident, including references to course preparation, Team Captains and Jury Meetings, inspections, training, homologation files and previous TD reports, related incidents, etc. Comments on actions after the incident including contact with the ski area management, information given to the media and media contact person, and contact with the accident victim, family an representatives after the accident. Your assistance in providing a complete record is important.In your view, who was responsible for the incident?Has blame been apportioned? Include an outline of any implied or actual threat of legal action arising out of the incident.
The information provided by this report is very important for Snowsport England records. It should be treated as private information and should not be released to the public, media, coaches etc.
This report will be treated as private by the Snowsport England.
Date: / Signature:

SSE TD Accident Report Form – Jan 2008