Activity Centre Near Miss / Incident Form – Mersey Weaver

At Mersey Weaver Scouts, the health and safety of all our customers and volunteers is vitally important. If you experience a Near Miss or Safety incident while using one of our facilities please let us know so we can ensure it can’t happen again.

Incident & Near Miss Form

Which Activity Centre / Resource does this relate to?*
Your Booking Reference
Your Name*
First Last
Are you part of UK Scouting or an external organisation?*
- UK Scout Association
- Other organisation
Membership Number*
Email*
Enter Email Confirm Email

In case we need to get in contact to gather further information about this incident
Was this an Incident or a Near Miss?*
- Incident
- Near Miss
Date the Incident/Near Miss occurred*
Date Format: DD slash MM slash YYYY
Where did the Incident/Near Miss take occur?*
Activity being undertaken when the incident or near miss occurred*
Description of the incident or near miss*
What happened, what went wrong, why it happened etc. The more details that you can provide here the more useful it will be in trying to ensure that this can't happen again.
Photographs or attachments
Drop files here or

Accepted file types: jpg, jpeg, png, gif, heic, pdf.
Do you have any photos of anything our team's attention should be brought to.

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Incident & Near Miss Form

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