Incident Report Contact Details Name * First Name Last Name Phone Email * Incident information Date MM DD YYYY Time Hour Minute Second AM PM Venue Description Outcome Additional information Exact location of incident Name(s) of people involved Were the people involved in a DWA managed program at the time? Yes No If yes, which program? Had the people involved ridden this, or similar runs, before? Yes No Did ski patrol attend the incident? Yes No Patroller name Snow conditions Road conditions Weather conditions Wind conditions Visibility conditions Action taken at the time of the incident and immediately after Were any injuries sustained as a result of the incident? Yes No If yes, list who was injured, nature of injury and treatment Was any equipment involved in the incident? Yes No If yes, please provide details Were there any witnesses to the incident? Yes No If yes, list witnesses Full names and contact details Who was this incident reported to? Date MM DD YYYY Thank you!We will be in contact shortlyDisabled Wintersport Australia
