Sports Facility Hazard Incident Report
Incident Details
Date of Incident
Time of Incident
Location
Description of Hazard/Incident
Persons Involved
Name(s)
Role(s) (e.g. player, staff, spectator)
Injuries Sustained (if any)
Witnesses
Witness Name(s)
Contact Information
Action Taken
Immediate Actions Taken
Reported To (Name/Role)
Date/Time Reported
Additional Information
Report Completed By
Name
Date