Activities Incident Report
If students are injured and require addition services or help or are not able to return to activity due to injury, please fill out immediately.
Student's Name *
Your answer
Grade *
Date of Injury
MM
/
DD
/
YYYY
Location of Incident *
Your answer
Description of Incident
Your answer
Outcome of Incident
Coach's Name
Your answer
Who is filling out form?
Your answer
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