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Website Designed and Maintained by Ray Dwyer

LITTLE LEAGUE

Ringwood, New Jersey

In the event of an injury to a player, umpire, coach, or spectator at a Ringwood Baseball event, the coach for the team who the injured party is affiliated with is asked to complete the following form for our records.  

This information is kept on file confidentially and will serve as a record should further assistance be needed for the injured party.

Any injury at the fields that require first aid treatment needs to be reported to the Ringwood Baseball Safety Director, Ray Dwyer.  Ray can be reached at raydwyer@optonline.net

Ringwood Baseball Injury Incident Report

Date of Injury

Injured Party

Description of Injury and Events Leading to Injury

Ringwood Baseball Injury Report Form

All Input Fields Required

Treatment Provided

Injured Party Address

Responding Agencies

Ringwood Police

Ringwood Ambulance

Was injured party transported to a hospital?

Injured Party’s Parents Name (if minor)

Injured Party’s Telephone Number

If so, which hospital?

Submitted by

Geographical location where injury occured

Released to Parents

If applicable, was injured party removed from the game?

If applicable, do you have any recommendations to help us avoid future injuries of this type?