Visitor Incident Form

Please fill this form out to report an incident that has happened on Canal & River Trust property (this includes towpaths, canals, rivers, reservoirs or buildings for example).

If you are getting in touch to report an issue relating to one of our navigations, towpaths or structures, or to make a general enquiry, please complete the Contact-Us form.

1. Details of the person reporting the incident

Title (optional)

First name

Last name

Telephone

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Address line 1

Address line 2 (optional)

City

Postcode

2. Details of incident

When did it happen?

Exact location of incident

0/4096 characters

What happened?

0/4096 characters

Did anyone need hospital treatment?

Yes

Don't know

Were the police informed?

Yes

Don't know

3. Details of injured person

First name (optional)

Last name (optional)

Email address (optional)

Telephone (optional)

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Address line 1 (optional)

Address line 2 (optional)

City (optional)

Postcode (optional)

Age (optional)

4. Details of injuries and damages to property/equipment

Details of injuries

0/4096 characters

Details of damage to property or equipment

0/4096 characters

Your privacy:

At the Trust, we take processing your data seriously and your details will be dealt with in accordance with the Trust's Privacy Notice and our website's Terms and Conditions.

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