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Incident / Near-Miss Report

Purpose: To record any abnormal event, safety concern, or near-miss, regardless of whether damage or injury occurred.

When to use: • Any collision, contact, or loss of control • Any guest or staff injury, however minor • Any safety-related incident • Any near-miss that could later be disputed • Any supplier, third-party, or public interaction of concern

Event Code

Reported By (Staff Name)

Location (As Specific As Possible)

People Involved

List all relevant individuals. Include guests, staff, third parties.

Injuries

Select the highest applicable level.

Vehicles Involved

List registration(s) or clearly identify the vehicle(s).

Vehicle Damage

Incident Description

Factual description only. What happened, where, and in what sequence. Do not assign blame or speculate.

Immediate Actions Taken

E.g. Vehicle removed from rotation. Guest assessed. Staff notified. Supplier contacted. Please refer to emergency procedures.

Photos And/Or Video

Accepts video, image, audio files

Upload any relevant photos or videos. In the event of damage, we need documentation.

Supplier Notified?

Emergency Services Involved?

Signature

Confirms this is an accurate contemporaneous record.