Incident Report
There may be times where an incident needs to be reported to MCLL regarding an injury or other event. Please complete the following questions in as much detail as possible so we can sufficiently understand what happened in order to address any changes or other actions that may be needed.
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Date and Time of Incident *
MM
/
DD
/
YYYY
Time
:
Location
Team or Person this report is about
Describe the incident
Other persons that witnessed the incident
Name of person submitting this report
Phone Number
Submit
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This form was created inside of Montgomery County Little League.