JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
FGPC & SWF Behaviour Incident Report Form
To be filled in after any specifically behaviour-related incidents involving FGPC/SWF coaches, staff, or athletes. Most of the questions are marked as required, so fill in "N/A" if not applicable.
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Date
*
MM
/
DD
/
YYYY
Time
:
AM
PM
Name of person filling out form
*
Your answer
Email
*
Your answer
Role of person filling out form
*
Your answer
Contact Info
*
If applicable
Your answer
Person who caused the incident
*
Your answer
Phone # and email for person who caused the incident
*
Your answer
Type of Incident
*
Select as many as applicable
Refusal to comply
Inappropriate Language or Slurs
Harrassment
Intimidation
Physical contact or injury
Indecent Act
Theft
Vandalism
Other:
Required
Quick Overview of Incident
*
Your answer
Detailed answer
*
Your answer
Were the police contacted?
*
No
Yes
Required
Police Case Number (if applicable)
If police were contacted, what is the case number
Your answer
Physical injuries and treatment (if applicable)
Detailed description of injuries and treatment
Your answer
Witnesses
*
Your answer
Was injury or damage caused to property
Your answer
*
Detailed description of action taken (if any)
Your answer
Corrective Action
*
Your answer
Follow-up
Management Action Taken (for GM/Board use)
Date of action taken (if applicable)
Your answer
Notes:
Your answer
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Fairway Gorge Paddling Club Society.
Report Abuse
Forms
