Free Sports Club Injury Report Form Template
Sports Club Injury Report Form
Please fill out this form immediately after any injury occurs. This information helps us ensure proper care and safety for all members.
Injured Member Information
Name
Date of Birth
Phone Number
Address
Injury Details
Date & Time of Injury
Place of Injury Occurrence
-
Gym
-
Field
-
Type of Activity During Injury
Injury Description
Part(s) of Body Injured
Type of Injury
-
Sprain
-
Cut
-
Severity
-
Mild
-
Moderate
-
Severe
Treatment Provided
First Aid Given
Describe Treatment (if applicable)
Witness Information
Name (if any)
Phone number
Member's Name:
Date:
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