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HVHS Sports - Serious Accident or Incident Form
All serious incidents must be reported to the Director of Sport within 72 hours in order for review and appropriate action to be taken if applicable.
A serious incident is when:
- It places the school into disrepute.
- Physical and/or verbal abuse on or off the field/court.
- Use & possession of illegal substances.
- Involvement in an incident by a representative of HVHS such as a coach, manager, player or supporter.
A serious accident that must be reported includes the following:
- Any broken bone during practice or at a game
- Any accident that has required the player to be removed from the game due to suspected concussion
- Any accident that requires professional medical attention by a doctor or a visit to A&E
- Any accident that is a result of misconduct by a student
Date of Accident or Incident
Approximate Time of Accident or Incident
Location of Accident or Incident
Name of injured person or person involved in incident
Type of Injury - e.g. broken bone, concussion
Injured person contact information: Contact number/address/role (player, volunteer, supporter)
Damaged property: Property damaged and nature of damage
Describe the accident/incident
What were the causes of the accident/incident?
How bad could it have been?
What is the chance of it happening again?
What has or will be done to prevent it from occurring again in the future?
Type of treatment given and name of first aider/doctor/hospital?
Your Name (person filling out form)
Your Contact number (person filling out form)
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This form was created inside of Hutt Valley High School.