Injury Report (St. Catharines CYO Hurricanes)

Print Injury Report
Please fill out all information. This form will be sent automatically to the Director of Risk, the President and the Secretary. It is imperative that any injury be documented in a timely fashion. Only when an injury is documented can we properly investigate and appropriately follow up.

  1. If the injury occurred during a league or team sanctioned event, you must also fill in the ALLIANCE INJURY REPORT FORM. This form is to be filled in by a physician and mailed to the address located at the bottom of the form.

Location of incident
Person Injured

Team Trainer
  1. Example: ###-###-####
Nature of Injury
  1. If YES, Hockey Canada concussion protocols must be followed.
  2. Check all that apply
  3. Check All That Apply
  4. Check all that apply
  5. Check all that apply

  6. Check all that apply
  7. Check All That Apply

  8. Check All That Apply
Injury Incident Report
Email confirmation
  1. Enter your email to receive a copy of this report.
Human Validation
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Printed from on Monday, January 18, 2021 at 4:54 AM