Softball Accident Report Form

SOFTBALL ACCIDENT REPORT FORM
This form must be submitted to the Softball BC Office within 30 days of the incident. If you have any questions please contact hpettifer@softball.bc.ca.

THIS IS NOT AN INSURANCE CLAIM FORM, please submit your claim HERE

Submit the Allsport Athletic Accident Claim Form to the address indicated on the form for Markel 400, 200 Wellington Street West, Toronto, ON M5V 3C7 or fax to 416-601-1150 or email to claims@markelintl.ca
Date of Injury

MonthDayYear
Location (Field/Park)
Team 1
Team 2
League
District
Category

Minor FastpitchMen & Women FastpitchMen & Women Slo-Pitch
INJURED PERSON Name
Softball BC Number
Mailing Address
Phone
Type of Injury
DESCRIPTION OF INJURY/ACCIDENT
WITNESS INFORMATION (Name, Address, Phone)
PERSON COMPLETING REPORT (Name, Address, Phone, Position with team)
Email Contact for person completing report
example@example.com
Should be Empty:

SOFTBALL ACCIDENT REPORT FORM