Safety Form
RCR OHS Safety Form 2025
Safety Form for Incident Reporting
Step
1
of
7
14%
Name
This field is for validation purposes and should be left unchanged.
Is this an immediate safety concern?
(Required)
Yes
No
Selecting No will allow you to continue with the report, but you must first alert your manager or supervisor.
Submitter's Name
(Required)
First
Last
Incident Date
(Required)
MM slash DD slash YYYY
Incident Time
(Required)
Hours
:
Minutes
AM
PM
AM/PM
Department of the individual involved in the incident
(Required)
Resort Site
(Required)
Fernie Alpine Resort | Lizard Creek Lodge
Kicking Horse Mountain Resort
Kimberley Alpine Resort | Trickle Creek Lodge | Trickle Creek Golf Resort
Mont-Sainte-Anne | Golf Grand Vallon
Nakiska Ski Area | Winter Green Golf
RCR Calgary Office
Stoneham Mountain Resort | Hotel Stoneham
Department Category of the individual involved
(Required)
Administration
Food and Beverage
Golf Course
Hotel
Instructors | Guides | Daycare
Lift Operations | Rail Park
Maintenance
Mountain Operations
Mountain Safety
Rental | Retail | Repair
Incident Class
(Required)
Injury
Property Damage
Near Miss
Injury Class
(Required)
Minor Injury – No Treatment Required
First Aid (Treated by Resort / Patrol)
Medical Aid (Treated at Hospital / Physio)
Property Damaged
(Required)
Vehicle
Buildings
Tools & Equipment
Infrastructure
Near Miss
(Required)
Injury
Vehicle
Buildings
Tools & Equipment
Infrastructure
Other
Incident Description
(Required)
Animal or Insect Bite
Assault
Chemical or Fuel Spill
Cold or Heat Exposure
Collision
Crush / Pinch
Cut / Abrasion / Scrape
Dropped Object
Electrocution
Fall
Fall from height
Fire or Explosion
Flood
Freeze
Harmful Substance Exposure
Loss of Control
Medical Condition
Release of Stored Energy
Repetitive Strain
Slip or Trip
Strain
Struck
Incident Description: Explain what, how and where the incident occurred?
(Required)
Please do not use names of employees involved. Please include location of where the incident occurred ex. ski run or restaurant name, base area etc.
Witness Name
First
Last
Skiing or Riding
(Required)
Yes
No
Driving a Vehicle or Equipment
(Required)
Yes
No
Injury Detail
(Required)
Arm | Wrist | Hand | Finger
Back | Shoulder
Chest | Abdomen | Stomach
Foot | Ankle | Toe
Head | Neck | Face | Eye | Ear | Nose
Internal | Psychological | Medical
Leg | Knee | Hip
N / A
