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RPKA Near Miss and Accident Form
Please fill in this form if you have any accidents or near misses when kitesurfing. This information will be used to help improve safety systems to stop near misses becoming hits hopefully reduce the number of accidents!
Discipline
Select
Kitesurfing
Wingfoiling
Name
First
Last
Date Time of Accident or Near-Miss
MM
/
DD
/
YYYY
Accident Type
Type of Accident
Kite Failure
Lines Failure
Harness Failure
Board Failure
Pilot Error
Equipment Setup Incorrectly
Accident Outcome
Accident Outcome
Near-Miss
No Injuries
Minor Injury to one person
Minor Injuries to multiple persons
Major Injury to one person
Major Injuries to multiple persons
Type/Make/Model/Size of Equipment Being Used
Narrative Description of Event; please put as much information in as you can!
