Home » Enroll a Child » Child Enrollment Forms » Kinship Incident Report Kinship Incident Report Child Name: First Last Phone:Volunteer Name: First Last Phone:Date of injury? MM slash DD slash YYYY Time of injury? : Hours Minutes AM PM AM/PM Where? Injury site: Type of Injury? Description of Injury:How did injury happen? Describe what you and others observed. What was the child doing? Where was the child? Please give a complete description of facts:First aid treatment by:Who took action? First Last Parent/Guardian notified?Select OneYesNoParent/Guardian: First Last Notified by: First Last What time was parent notified? : Hours Minutes AM PM AM/PM How was parent notified? Search for: Recent News Group Activities with a Purpose March 24, 2022 You Can Mentor (Podcasts) December 11, 2020 Champions For Change June 4, 2020 The kids aren’t all right: Why mentees will be disproportionately affected by the pandemic April 30, 2020 Coronavirus Disease 2019 (COVID-19) Stress and Coping April 30, 2020 There are no upcoming events at this time.
