BC Games Intake Report
Why are you making this report?
Something happened to me. I am making this report for myself.
I witnessed something or am reporting on behalf of someone else.
I am making record of this report/taking this report via a Games intake process
Name of Person Making the Report
Role of Person Making the Report
Games Intake Line Staff
Games Intake Volunteer
Day Report is being made
Wednesday
Thursday
Friday
Saturday
Sunday
Time Report in being made
Name of Person Making the Report
Games Role(s) of Person Making the Report
Athlete
Coach (Head Coach, Assistant Coach, Mentor/Apprentice)
Adult Supervisor
Official
Parent of Participant
PSO Rep or Provincial Advisor
Spectator/Bystander
Volunteer
Other
Email of Person Making Report
Phone Number of Person Making Report
Incident involves:
Participants in one sport
Participants in more than 1 sport or participants and volunteers
Only volunteers
Other
Nature of Incident
Other Details of Incident
Date of Incident
Time of Incident
Location of Incident
Sport(s) of people involved
Artistic Swimming
Athletics
Baseball
Basketball
Beach Volleyball
Box Lacrosse
Canoe/Kayak
Field Lacrosse
Golf
Rowing
Rugby
Sailing
Softball
Swimming
Towed Water Sports
Triathlon
Ultimate
Volleyball
Wrestling
Not a sport
Other
Incident Occurred During:
Competition
Opening Ceremony
Participant Special Event
Food Venue
On Games Transportation
At Games Accommodation
Other
Is the person making the report, the victim?
Yes
No
Victim's Name
Victim's Role with the Games
Athlete
Coach (Head Coach, Assistant Coach, Mentor/Apprentice)
Adult Supervisor
Official
Parent of Participant
PSO Rep or Provincial Advisor
Spectator/Bystander
Volunteer
Other
Victim's Contact Number
Victim's Email
My Name
My Role with the Games
Athlete
Coach (Head Coach, Assistant Coach, Mentor/Apprentice)
Adult Supervisor
Official
Parent of Participant
PSO Rep or Provincial Advisor
Spectator/Bystander
Volunteer
Other
My Contact Number
My Email
Name and Contact Information of Witnesses
Were the police or social services contacted?
Yes
No
Not sure
Response/Info Given to the individual making the report
Other info to pass on
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