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.
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Date *
MM
/
DD
/
YYYY
Full name of person injured *
Time and date of injury *
Description of injury *
When and how did it occur *
Further Action? *
Parent/ Caregiver notified
Clear selection
Name of person reporting *
Submit
Clear form
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