WGI Incident Report

Step 1 of 6

Date(Required)

Division(Required)

Name of Person Completing this Form(Required)

First Last

Position of Person Completing this Form(Required)

i.e. Site Manager, Booster Parent, Nurse, Athletic Trainer, Contest Administrator

Email of Person Completing this Form(Required)

Phone of Person Completing this Form(Required)

WGI Event(Required)

Venue(Required)

Location of Incident(Required)

i.e. Performance Gym, Warm Up, Hallway, Outside

Person(s) involved, if more than one, please complete an additional form.

Name(Required)

First Last

Birthdate(Required)

Gender(Required)

Address(Required)

Street Address City State / Province / Region ZIP / Postal Code Country

Primary Phone Number(Required)

Upload photo of Driver's License or State ID

Max. file size: 100 MB.

*If applicable

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