Summer Camp Incident Report

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I. Incident Details

• Date: June 15, 2050

• Time: 2:30 PM

• Location: [Camp Address]

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II. Description of Incident

June 15, 2050, at approximately 2:30 PM, an incident occurred at [Camp Address] during a canoeing activity. A camper, [Your Name], sustained a laceration to his right leg while attempting to disembark from a canoe. The injury was assessed to be moderate.

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III. Parties Involved

• Camper: [Your Name]

• Camp Staff: [Your Company Name]

• Witnesses: [Names of any Witnesses, if applicable]

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IV. Injuries or Damages

The injured camper, [Your Name], sustained a 3-inch laceration to his right leg. Upon assessment by camp medical staff, it was determined that the injury required stitches.

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V. Actions Taken

• Immediate First Aid: Camp staff provided first aid, including cleaning the wound and applying a sterile bandage to the injured camper, [Your Name]

• Notification: Camp management was promptly informed of the incident.

• Medical Attention: [Camp Address] was transported to the camp infirmary for further assessment and treatment.

• Parent/Guardian Notification: [Your Name]'s parent/guardian, [Parent/Guardian Name], was contacted and informed about the incident and the medical attention being provided.

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VI. Follow-Up Actions

• Incident Documentation: This incident report was promptly filled out by [Your Company Name] to document the details of the incident.

• Review of Safety Procedures: Camp management will review the circumstances surrounding the incident to identify any potential improvements to safety procedures or protocols.

• Monitoring: Camp medical staff will continue to monitor [Your Name]'s condition and provide any necessary follow-up care.

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VII. Witness Statements

• [Insert Witness Name], [Insert Relation to Camp or Camper], stated: "[Insert Witness Statement]"

• [Insert Witness Name], [Insert Relation to Camp or Camper], stated: "[Insert Witness Statement]"

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VIII. Signature of Staff Member Filing Report

[Staff Name]

[Your Company Name]

[Your Position]

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