Notication of Accident
or Incident
This form should be completed by an adult member of Girlguiding as soon as possible after an
accident or incident. Please complete the whole of the form and attach any relevant witnesss
statements, forms or documents. This is not an insurance claim form – it is purely for notication.
Please keep a copy of the form until receipt is acknowledged by HQ and then safely destroy it in
line with GDPR.
If you have any queries about this form, please contact the Girlguiding insurance department
via email insurancesupport@girlguiding.org.uk or via the helpline on 0845 260 1053.
We collect your personal information to provide incident related support, process insurance claims and other legal purposes.
We may share your data with:
• Insurance companies
• Legal representatives
• Regional and local Girlguiding organisations
We process the data you provide under our legitimate interests of managing insurance on behalf of our membership.
For further information on how and why Girlguiding use your personal data, including how long we keep it, your rights,
and how you can contact us, please read our full privacy notice at: girlguiding.org.uk/privacy-policy/
Injured person
Name ________________________________ Membership number____________________________
If the injured person is not a Girlguiding member, please provide their details below.
Date of birth ___________________________
Address
Telephone number _________________________ Email address _____________________________
Next of kin (if injured person is under 18)
Name ______________________________________________________________________________
Relationship to injured person __________________________________________________________
Contact
details
Leader
Name ________________________________ Membership number____________________________
Level name ___________________________ Level number __________________________________
