Your contact details

Full name*

Contact number*

Email address*

Incident details

Date*

Time*

Category*

Venue*

Description*

Role of person reporting (Coach, Cox, Crew)

Incident at Pre-dawn, Dusk or Poor light?

If so, what lights were displayed by each party?

YYRC boat(s) involved in the incident: Boat name(s)

YYRC crew members in the boat(s) at the time of the incident

Were other parties involved in the incident?

If yes, what Club(s) and boat(s) were involved?

Were any injuries sustained to anyone?

If any injuries were sustained, please provide details

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List the damage sustained to boats or property

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Have you exchanged contact info? If so, please provide details

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Are there any additional comments you think could be useful

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