Accident Register
This register is filled in for incidents at Knox Church Waitara where no further action is needed. If any follow up is required (due to injury, complaint, hazard or concern) please fill in an incident report.
Date *
MM
/
DD
/
YYYY
Full name of person injured *
Your answer
Time and date of injury *
Your answer
Description of injury *
Your answer
When and how did it occur *
Your answer
Further Action? *
Parent/ Caregiver notified
Name of person reporting *
Your answer
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