Employee Safety Incident Report
Report and document safety incidents involving amusement park staff.
Employee Full Name
*
First Name
Last Name
Employee Contact Information (Phone or Email)
*
Date and Time of Incident
*
-
Month
-
Day
Year
Date
Hour Minutes
AM
PM
AM/PM Option
Location of Incident (Ride/Attraction/Area)
*
Type of Incident
*
Please Select
Slip, Trip, or Fall
Equipment Malfunction
Employee Injury
Guest-Related Incident
Fire or Electrical
Other
Describe the Incident in Detail
*
Were there any injuries?
*
Yes
No
If yes, describe the injuries and name(s) of those injured
Witness(es) Name(s) and Contact Information
Immediate Actions Taken (First Aid, Equipment Shutdown, Supervisor Notified, etc.)
*
Upload Supporting Files (photos, reports, etc.)
Upload a File
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Employee Signature
*
Submit Incident Report
Submit Incident Report
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