Incident Reporting Form
This form is used to report incidents related to the use of school facilities.
Email *
Activity/Event: *
Group/Organization: *
Date of Incident: *
MM
/
DD
/
YYYY
Location of Incident: *
Person in charge of activity/event: *
Phone Number:
Summary of the Incident:
(Please provide as much detail as possible - names of parties involved, times, cause, response time, etc.)
 *
Witnesses: *
Group/organization's response to incident:
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