Ridge Baseball Club Incident Report
Name of person reporting this incident
*
First Name
Last Name
Your email address
*
example@example.com
Your phone number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Date and Approximate Time of incident
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Hour Minutes
AM
PM
AM/PM Option
Type of Incident Being Reported
*
Please Select
Property Damage
Injury
Other
The person injured was:
*
Please Select
Player
Coach
Umpire
Spectator
Location of incident
*
Name of person injured (if you don't know enter unknown)
*
Please provide a detailed explanation of what happened
*
Was emergency medical treatment given?
*
Please Select
Yes
No
Unknown
Who provided the emergency treatment?
*
Please describe the emergency medical treatment given
*
What property was damaged and where was it located?
*
Please describe the incident in as much detail as possible
*
Do you know the approximate cost to repair the damaged property?
*
Please Select
Yes
No
What is the approximate cots to repair the damaged property?
*
Please describe the "Other" incident you are reporting in as much detail as possible
*
Were the police called to the scene?
*
Please Select
Yes
No
Unknown
If known, what police department was called and what is the name of the officer who responded?
*
Please identify any other known witnesses to the incident
*
Please provide any other details you would like us to know about the incident
Please verify that you are human
*
Submit
Should be Empty: