Injury/Incident Report

This Injury and Incident Report Form is used to document any injuries, accidents, or unsafe occurrences that take place during league games, practices, or related activities. The purpose of this form is to ensure accurate reporting, support follow-up actions, and maintain a safe environment for all participants. Coaches, officials, volunteers, and staff should complete this form as soon as possible after an incident occurs. Information collected includes details about the individuals involved, the nature of the injury or incident, contributing factors, witnesses, first aid or medical care provided, and any recommended corrective actions. Submitted reports help the league improve safety procedures, track recurring issues, and provide necessary documentation for insurance or medical follow-up.

 

Your Name
Your Phone Number
Your Email
What Athletics Program did this occur at?
Field # if applicable?
Name of person injured or involved with incident
Is person an adult or minor?
IF minor, where parents notified?
Phone number of person involved
Email of person involved
Description of injury or incident
Any Witnesses?
Witness Description
Verification

Required Fields