NOTE: All identifying information provided to Hover STAR Network will be kept strictly confidential. Names, specific locations, dates, times and other details are not released as part of any reports made or prepared by Hover STAR Network.
Directions: Use the following electronic form to send an Incident/Accident report. If you prefer, you may print out the hard copy form at the bottom of the page and forward the completed form to:
STAR Network, P.O. Box 500, Hawley, PA 18428 USA
Hovercraft Incident/Accident Report Form
Note: If this was an equipment-related incident, please provide as much detail as possible regarding the specific equipment involved (Manufacturer, model, serial number, etc.) Provide relevant background on factors you believe may have contributed in some way to the accident or incident.
Note: As part of ensuring the authenticity of information provided, or to obtain additional pertinent data, we may wish to contact reporters by phone, mail or email.Again, reporter name and other identifying information will be kept strictly confidential.
Hovercraft Incident/Accident Report Form (HARD COPY VERSION)
1) Location where incident/accident occurred:
2) Date/Time:
3) This report relates to an: (check one)
___ Incident (Something that went wrong that could have resulted in injury)
___ Accident (personal injury, damage or loss)
___ Fatality
4) If this was a fatality, was the accident reported to the proper authorities (Police, USCG, etc.)?
___ Yes
___ No
5) This report describes a situation, incident or accident that was primarily: (check the category that best applies.)
___ Equipment-related
___ Procedure-related
___ Environment-related
___ Maintenance-related
___ Other
6) This report describes a situation that involved (check all that apply):
___ Loss or near-loss of control of the craft.
___ Collision with another object or vessel.
___ Failure of the engine, lift or thrust system.
___ Failure of another system or component.
___ Onboard fire.
___ Personal injury.
___ Passenger/operator overboard.
7) Operating conditions or environment at the time of the incident or accident included (check all that apply):
___ Night
___ Flat Water (pond, lake, etc.)
___ White Water
___ High Winds
___ Snow
___ Ice
___ Thin or broken ice over water
___ Sand
___ Desert/Salt flats
___ Mud/Mudflats
8) The activity ongoing at the time is best described as:
___ Recreation
___ Training
___ Racing
___ Fire Department/Search & Rescue/Sheriff’s Department
Note: If this was an equipment-related incident, please provide as much detail as possible regarding the specific equipment involved (Manufacturer, model, serial number, etc.) Provide relevant background on factors you believe may have contributed in some way to the accident or incident.
10) Did this incident or accident involve a unique environment or situation, such as night operations, white water, search and rescue, etc.? If so, please explain...
11) Had the operator been formally trained in hovercraft operation?
12) Did the operator have special training or certification for the specific activity being conducted?
13) Describe any recommendations you would make as a result of this situation:
14) Operator Experience:
Total hovercraft experience (years/operating hours) ____
Experience in the past year ____
Experience within the past month prior to incident/accident ____
16) How Can We Contact You?
Note: As part of ensuring the authenticity of information provided, or to obtain additional pertinent data, we may wish to contact reporters by phone, mail or email.Again, reporter name and other identifying information will be kept strictly confidential.
