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