RBLL Incident & Injury Report
Please provide us with the details related to any incidents or injuries that occur at a RBLL sanctioned activity. These details will be provided to our League President and Safety Director, but will otherwise be kept confidential.
Email *
Date of Incident *
MM
/
DD
/
YYYY
Time of Incident *
Time
:
Location of Incident *
Your Team and Division *
Opposing Team (if applicable)
Description of Incident *
Did an injury occur as a result of the incident? *
Please provide details of the injury 
Please list rule violations that are being alleged (if applicable)
Please list all persons involved in the Incident *
Please list any witnesses to the incident
Your Name *
Your Phone Number *
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