2025 Wellesley Youth Baseball & Softball Injury Report Form
Date
-
Month
-
Day
Year
Date
Name of person filling out report
First Name
Last Name
E-mail
Phone Number
-
Area Code
Phone Number
Field where incident took place
Ex. Reidy, Lee, Kelly, etc.
League Name
Ex. Junior Softball, Majors Baseball, etc.
Team Name
Ex. Pirates, Raiders Blue, Grasshoppers, etc
Injured person's name
Was the injured person...
Please Select
Player
Coach
Umpire
Spectator
Other
Home team should submit form if umpire was injured
Severity of injury - check as many as apply
Injured person was hit in the head
Injured person had to leave the game
Injured person needed medical attention (ie. ice pack, bandage)
Injured person required immediate 911 attention
Please state the nature of the injury and a short description of what took place
Was the injured person transported to the hospital?
Yes
No
If YES, what hospital
If unsure, leave blank.
Thanks for filling this out. Our Safety Officer will be contacting you to follow-up. If you have any questions or concerns, please email us: wellesleyybs@gmail.com
Submit Injury Form
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