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INCIDENT/ACCIDENT REPORT FORM Camper s Name Date Address Street City State Zip code Name of Person Involved Last First Age Sex Position Camper Paid Staff Volunteer Staff Middle Visitor Phone Name of Parent/Guardian if Minor Names/Addresses of Witnesses 1. Type of Incident Behavioral Accident Epidemic Illness Other Date of Incident/Accident Time am pm Describe the Event and details of the injured person Where did it occur Be specific and use locations and names of witnesses Was injured...
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Phone/Fax: Other Comments: This includes everything from “Did you know that the average length of stay in a campground across the US is 30 days.” to “Your camping trip may be over at noon tomorrow.
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