Due to the steepness and uneven surface of Cooper's Hill, there are usually a number of injuries each year. A first aid service is provided by the local St John Ambulance (Gloucester, Cheltenham and Stroud Divisions) at the bottom of the hill. Members of the local rugby club and Young Farmers volunteer their services by acting as 'catchers' for any participants who lose their balance and also are on hand to carry down any casualties requiring first aid who do not reach the bottom. A number of ambulance vehicles attend the event, since there is invariably at least one and often several injuries requiring hospital treatment.