Facility Report Form

Team Hallam Facility Report Form


Your Name:

Date of Incident:

Time of Incident (approx):

Sports Club:

Facility incident occured at (please give exact address if known):

Please describe what happened and any action taken

Give as much detail as you can in the text box below, or alternatively, upload a statement or diagram

Did a member of staff at the facility help?

  YES     NO

Was a member of Team Hallam Staff Contacted to help?

  YES     NO

Is there any other information you would like to provide?