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Accident Report

Accident Reporting:

Click here for the form:  Pequannock Accident form

What to report: An incident that causes any player, manager, coach, umpire, or volunteer to receive medical treatment and/or first aid must be reported to the Safety Officer. This includes the evaluation of the extent of the injury.

When to report: All such incidents described above must be reported to the Safety Officer within 24-48 hours of the incident. The Safety Officer is Billy Doty.

Cell: (973) 725-9845

E-mail: [email protected]

How to make the report: Coaches MUST Complete the online Accident/ incident report. Please fill out the Form to the best of your ability and save a copy to your local PC when complete. Then, email this document as an attachment to [email protected]..  We would prefer to have the coach or league official complete the accident form in your own words.  At a minimum, the following information must be provided:

-The name and number of the individual involved.

-The team and league of the injured player.

-The date, time, and location of the incident.

-As detailed a description of the incident as possible.

-The preliminary estimation of the extent of any injuries.

-What type of treatment was given by you or others?

-The name and phone number of the person reporting the incident.

Safety Officer's Responsibilities: Within 24-48 hours of receiving the incident report, the Director of Safety will contact the injured person or his/her parents and:

(1) verify the information received;

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Pequannock Little League

PO Box 364 
Pequannock, New Jersey 07440

Email Us: [email protected]
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