Incident Report

Used for kids camp, youth camp, winter retreat and other related events to document injury, illness, behavior, or sexual abuse.

Name of Event

Info about you (incident reporter)

Your Name
Name of person filling our incident report form.

Info about person involved in incident

Name of Person Involved

Info about the incident

Type of Incident

MM slash DD slash YYYY
Approximate Time of Incident
Include staff, adult leaders, and other students. Document witness statements as needed.
What led up to the event? What happened?
Contact Parents?

Sent to hospital?
Upload any useful images
Accepted file types: jpg, jpeg, png, gif.