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Athletic Accident Report
Student/Employee Name
*
School
*
CHS
CFA
SGS
PCIS
LES
LPS
MES
PCES
RES
SES
WES
ELC
ALC
ESC
Grade
*
12
11
10
9
8
7
6
5
4
3
2
1
K
Athletic Sponsor/Coach
*
Sponsor/Coach Email
*
Date of Accident
*
+
Time of Accident
*
Location of Accident
*
Description of Accident
*
Was there an injury?
*
Yes
No
Explain the injury
*
Please list or describe any actions taken by employees or medical professionals
*