SBP Incident Report
Please provide South Bay PONY with the details related to any Incidents that occur at an SBP game, practice, event, or other league sanctioned activity. These details will be provided to our League Safety Director and League President, but will otherwise will be kept confidential. You can feel free to contact our Safety Director at safety@southbaypony.com if you have additional questions.
Date of Incident
MM
/
DD
/
YYYY
Time of Incident
Time
:
Location of Incident
Your answer
Team
Your answer
Opposing Team (if applicable)
Your answer
Description of the Incident
Your answer
Did an Injury occur as a result of the Incident?
Please Provide Details of any Injury
Your answer
Issues that lead up to the Incident
Your answer
Specifically when, where, and how did the Incident occur?
Your answer
Please list Specific Rule Violations that are being alleged (if applicable)
Your answer
Please list all persons involved in the Incident
Your answer
Please list Witnesses to the Incident
Your answer
Please provide any Steps the Manager has taken to Remedy the Situation.
Your answer
Reporting Party Name
Your answer
Reporting Party Contact Information (cell phone or email)
Your answer
Additional Information you would like to Provide
Your answer
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