Island Baseball League – Incident Report

- Incident Report -

Incident Report Form.

Use this form to report accidents, injuries, medical/COVID situations, or behavior incidents.

(Incidents involving a crime or traffic incident should be reported directly to the Middletown Police Department. Medical emergencies please dial 911)

If possible, the report should be completed within 24 hours of the event.

Date Report Completed:*

Individual Submitting Report:

Name

First Last

You can fill this out as anonymous.

Email*

Contact Phone:

Title/Role*

Incident Information

Time of Incident (Approx.)

: HH

MM

Date of Incident:*

Incident Type:*

Description of Incident:*

Police Report Submitted?

Player or Parties Involved

List of players involved in incident.

Player One (Involved):

First Last

Player Two (If Applicable):

First Last

Player Three (If Applicable):

First Last

Player Four (If Applicable):

First Last

Witnesses

Please list three witnesses involved.

Witness One:

First Last

Witness Two:

First Last

Witness Three:

First Last

Player
Captain/Co-Captain
Bystander

No
Yes