ESPC Incident Log

ESPC Incident Log

To be completed to report any incident that occurs whilst attending an ESPC activity.

Please respond to all questions that apply to the incident you are reporting.

Date of incident:

Clinic/Activity:

Venue:

Instructor:

Name of person involved in incident:

Name of Pony/Horse

Was the rider unseated?

Yes

No

Did the rider continue riding following the incident?

Yes

No

Did the pony/horse fall?

Yes

No

Was a vet required?

Yes

No

Other Incident (ie. non-riding):

Yes

No

Where did the incident happened:

Time:

Brief account of what happened:

Was medical assistance given?

Yes

No

Is the Parent/Guardian aware?

Yes

No

Form competed by (Full Name):

Thank you for the information

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East Sussex Pony Club

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East Sussex Pony Club

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