TVYFL Participant Injury Report - DYF
To be completed by approved coach or board member.
Organization *
Head Coach *
Injury Date/Time *
MM
/
DD
/
YYYY
Time
:
Injury Location *
Activity *
Level *
Injured Name *
Injured Description
body parts & injury
How did it happen?
who, what, where & how
Treatment
1st aid, medical, ambulance called, etc
Witness Names (1-3) *
List witness name and phone number.
Report Written Date/Time *
MM
/
DD
/
YYYY
Time
:
Report Writers Full Name and Title
Report Writers phone number
Report Writers Email address *
Submit
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