Cheerleading Performance Injury Report
Incident Details
Date of Incident
Time of Incident
Location
Performance Name/Event
Coach/Supervisor
Injured Person
Name
Age
Team Role/Position
Injury Information
Type of Injury
Part of Body Injured
Describe How the Injury Occurred
Immediate Action Taken
Witness Information
Witness Name(s)
Follow-Up
Follow-Up/Additional Notes
Report Completed By
Date