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About Us
Classes
Tiny Sparks
Fundamentals Cheerleading
Fundamentals Gymnastics
Allstar Cheer & Dance
To Busy To Browse?
Superficial Accident Form
This form is for the reporting of minor injuries that require nothing more than a plaster, ice pack etc.
If the incident is more severe please use the other form.
**REMEMBER IF THE INCIDENT IS SEVERE PLEASE SEEK PROFESSIONAL ASSISTANCE**
Student Name
(Required)
First
Last
Coaches Name
(Required)
First
Last
Date of Incident
MM slash DD slash YYYY
Time of Incident
(Required)
Time as near as possible to the incident taking place.
Hours
:
Minutes
AM
PM
AM/PM
Space where the incident happened
(Required)
Tinies Studio
Cheer Gym
Dance Gym
Reception
Bathroom
Outside
Other (comment below)
Other place incident happened write here
Items given out
(Required)
Please indicate the items that where used to treat this incident
Antiseptic wipe
Plaster
Ice pack
Other (comment below)
Select All
Other items used please write below
Thank you for sending the form. We will check it and get back to you if we require further information.
Δ
Minor Accident Form
Cuts, scrapes, etc
Superficial Accident Form
This form is for the reporting of minor injuries that require nothing more than a plaster, ice pack etc.
If the incident is more severe please use the other form.
**REMEMBER IF THE INCIDENT IS SEVERE PLEASE SEEK PROFESSIONAL ASSISTANCE**
Student Name
(Required)
First
Last
Coaches Name
(Required)
First
Last
Date of Incident
MM slash DD slash YYYY
Time of Incident
(Required)
Time as near as possible to the incident taking place.
Hours
:
Minutes
AM
PM
AM/PM
Space where the incident happened
(Required)
Tinies Studio
Cheer Gym
Dance Gym
Reception
Bathroom
Outside
Other (comment below)
Other place incident happened write here
Items given out
(Required)
Please indicate the items that where used to treat this incident
Antiseptic wipe
Plaster
Ice pack
Other (comment below)
Select All
Other items used please write below
Thank you for sending the form. We will check it and get back to you if we require further information.
Δ
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Your Name
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Last
Your Email Address
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Your Phone Number
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