Home
About Us
About Us
Board Of Directors
Contacts
Programs
Program Overview
Athlete Development Program
Camps for Young Athletes
Sprints and Hurdles Program
Middle and Long Distance Program
Multi Events Program
Varsity Program
Masters Program
Registration
Registration
Two Week Trial
Fees
Sport Manager Login
TeamSnap Login
AthleticsReg (AA Membership)
Meets & Schedules
Training Schedule
Track Meets
Meet Schedule
Meet Registration
Relay Registration
Volunteering
Volunteering Policy
Bingo and Volunteering
Bingo Sign Up
Officiating
Bingo Policy
Casino Worker Application
Coaches
Coach Llew Edwards
Coach Kenneth Wright
Coach Deon Flynn
Coach Christine Laverty
Coach Alex MacEachern
Coach Eric Evans
Coach Richard Gallimore
Coach Rebeca Agoston
Coach William Lee
Resources
Code of Conduct
Chaperone Code of Conduct
Athlete Code of Conduct
Expense Reimbursement Form
Competition Support Request
Policies
Competition Support Policy
Respectful Communication & Code of Conduct Policy
AADP Funding Policy
Athlete Assistance Policy
Credit & Refund Policy
Scholarships and Funding
Emergency Action Preparedness Plan
Emergency Action Preparedness Plan
Incident Report Form
Travel Meet Form
Travel Consent
Consent – National
Consent – International
Bylaws
Menu
Home
About Us
About Us
Board Of Directors
Contacts
Programs
Program Overview
Athlete Development Program
Camps for Young Athletes
Sprints and Hurdles Program
Middle and Long Distance Program
Multi Events Program
Varsity Program
Masters Program
Registration
Registration
Two Week Trial
Fees
Sport Manager Login
TeamSnap Login
AthleticsReg (AA Membership)
Meets & Schedules
Training Schedule
Track Meets
Meet Schedule
Meet Registration
Relay Registration
Volunteering
Volunteering Policy
Bingo and Volunteering
Bingo Sign Up
Officiating
Bingo Policy
Casino Worker Application
Coaches
Coach Llew Edwards
Coach Kenneth Wright
Coach Deon Flynn
Coach Christine Laverty
Coach Alex MacEachern
Coach Eric Evans
Coach Richard Gallimore
Coach Rebeca Agoston
Coach William Lee
Resources
Code of Conduct
Chaperone Code of Conduct
Athlete Code of Conduct
Expense Reimbursement Form
Competition Support Request
Policies
Competition Support Policy
Respectful Communication & Code of Conduct Policy
AADP Funding Policy
Athlete Assistance Policy
Credit & Refund Policy
Scholarships and Funding
Emergency Action Preparedness Plan
Emergency Action Preparedness Plan
Incident Report Form
Travel Meet Form
Travel Consent
Consent – National
Consent – International
Bylaws
Incident Report Form
Download PDF
Incident Report Form
Personal Information
Name of Injured
*
Phone # of Injured
Gender
Date of Incident
Time
12
1
2
3
4
5
6
7
8
9
10
11
:
00
15
30
45
AM
PM
Birthdate
Injured Person
Athlete
Coach
Official
Volunteer
Parent
Other
Injured Person
Parent or Guardian
Phone # of Parent or Guardian
Description of Incident
Event
Meet
Club Practice
Location of Incident
Description of Incident
Upload Photos or Videos, if available
Drop a file here or click to upload
Choose File
Maximum upload size: 52.43MB
Upload Photos or Videos, if available
Drop a file here or click to upload
Choose File
Maximum upload size: 52.43MB
Upload Photos or Videos, if available
Drop a file here or click to upload
Choose File
Maximum upload size: 52.43MB
Treatment
Describe On-Site Treatment
Person Administering First Aid
Outcome
First aid only
Taken to hospital
Refused care
Taken to clinic
Picked up by guardian
Other
Outcome
Follow-Up Needed
Yes
No
Witnesses
Witness #1 Name
Witness #1 Phone
Witness #2 Name
Witness #2 Phone
Name of Person Completing Report
*
Phone
*
If you are human, leave this field blank.
Submit
Contact us today
Facebook-f
Instagram
Envelope
My Account
Sport Manager Login
TeamSnap Login
Make a Payment
Renew A A Membership
Sign up for a Bingo
New Athletes
Two-Week FREE Trial
Register Now
Get A A Membership
Locations
Contact Us
Athlete Coordinator
Registrar
Admin
Bingo
Volunteer
