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502 Dragons Incident Report
Please complete as much information as you can as soon as possible after the incident. All incident reports should be completed within 24 hours of the incident; sooner is better! Thank you!
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* Indicates required question
Email
*
Your email
This form is documenting:
*
an injury
first aid
incident
close call
observation
damage to equipment or facilities
Other:
Name of person completing form
*
Your answer
Best phone number for person completing form
*
Your answer
Any other parties or witnesses we should speak to? Please provide names and contact methods if possible.
Your answer
Date incident occurred:
*
MM
/
DD
/
YYYY
Time incident occurred:
*
Time
:
AM
PM
What happened? Describe what happened/sequence of events.
*
Your answer
How was the situation resolved?
*
Your answer
Was the event, damage, or injury caused by an unsafe act (activity or movement) or an unsafe condition (equipment or weather)? Please explain.
Your answer
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