Incident Report (online)
Name
*
First Name
Last Name
Member #
*
Date of incident
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
1
2
3
4
5
6
7
8
9
10
11
12
:
Hour
00
10
20
30
40
50
Minutes
AM
PM
AM/PM Option
Phone Number
*
-
Area Code
Phone Number
Email
*
Location Incident Occurred (check all that apply)
100/200 Yd. Bench Area
50 Yd Bench Area
Pistol Area
Shotgun Area
Parking Area
Downrange
Other
Bench Number
Did you contact the person and discuss the issue?
NO
YES
Describe the incident:
Identify Person(s) involved in incident; needed to contact them
If known include name, member #, vehicle description/license.
Name & phone of witness
Upload picture of logbook or other pertinent photos.
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