Marshal Injury Report


SCA Name: Membership #:
Legal Name: Expiration date:
E-mail Address:
Phone:
Sponsoring Branch:

Injury occurred on:
Injury occurred during: Practice    Tournament    Other
 
Name of Injured Party
Legal Name: SCA Name:

Nature of Injury
Describe the incident
In your opinion, the injury occurred due to:
Equpiment Failure    Inadequate Equipment    Inadequate Marshalling    Inadequate Training    Other
Describe the cause
How could this have been prevented

Email Addresses of up to four other people you would like copies of this report forwarded to:
The report is automatically sent to the Earl Marshal, Regional Missile Marshal, and the submitter.
There is no need to enter any of those email addresses in the spaces above.