HFSC Incident Report
Skater
First Name
Last Name
Reporter
First Name
Last Name
Bystander(s)
Location
Date of incident
Describe the incident with as much detail as possible.
Was first aid treatment administered? If so, by who?
Was a family member/emergency contact notified? If so, who?
Transport Needed
Yes
No
Reporter's Signature
Date of Signature
-
Month
-
Day
Year
Date
Submit
Should be Empty: