Australian Clay Target Association logo

National Office

02 6938 2121

Email Us

Draft copy of Proposed New Constitution - please click here to download

Incident Report Form

This form is to be used to report all injuries, illnesses, or near misses, whether an injury occurred or not, and to document the investigation.
Please complete within 24 hours of the incident.

Required fields in the form are marked with an *


SECTION A: TO BE COMPLETED BY PERSON INVOLVED

DETAILS OF PERSON INVOLVED


DETAILS OF THE INCIDENT


PART OF BODY AFFECTED


DETAILS OF THE INCIDENT/INJURY/NEAR MISS


SECTION B: TO BE COMPLETED BY THE SUPERVISOR & THE PERSON INVOLVED WITHIN 48 HOURS

This is an extremely important section as the aim of the incident investigation is to identify preventative action that will avoid recurrence.

DETAILS OF THE CAUSE OF THE INCIDENT/INJURY/NEAR MISS


PREVENTION OF INCIDENT RECURRENCE


DETAILS OF PROFESSIONAL SERVICES INVOLVED


LOCAL ADMINISTRATORS DETAILS


Thank you for completing the online Incident Report Form.
By submitting this form you accept responsibility to the actual events and outcomes possibly attained from this incident as a true statement.

June 2021 CTSN

On the cover: Zane Karlsson, Overall High Gun - NT Sporting Carnival

Inside this month's edition

ACTA Report
NTCTA Sporting Carnival
ACTA News
VCTA ISSF Championships
Opening of Mildura Shot Curtain
Coaching News
2021 Mildura Easter Carnival
ACTA State Rules Supervisors
Monarto’s 39th Anniversary
Psychological Skills for Shooting
Break Badges
Competition Results: WA, QLD, VIC, NSW, SA, TAS, NT
Good Scores at Bega
Classifieds
ACTA New Members
Shoot Calendar


Download PDF          View FLIPBOOK
This month's CTSN

Call the National Office

02 6938 2121