Archery Equipment Release Issue Report Form
Report an issue involving released archery equipment, including what happened, which equipment was involved, where and when it occurred, and any injury or damage details.
Reporter Information
Full Name
*
First Name
Middle Name
Last Name
Relationship to Participant or Incident
*
Please Select
Participant
Coach
Staff
Parent/Guardian
Witness
Other
Best Contact Information (Email or Phone)
*
Incident Details
Date of Issue
*
 -
Month
 -
Day
Year
Date
Approximate Time
Hour Minutes
AM
PM
AM/PM Option
Location / Venue
*
Description of Incident
*
Archery Equipment Information
Equipment Type
*
Please Select
Bow
Arrow
Release Aid
Quiver
Arm Guard
Finger Tab
Other
Equipment Identifier or Label
Condition at Time of Issue
*
Functioning Normally
Damaged
Malfunctioning
Missing Parts
Unknown
Impact and Follow-Up
Did any injury, near-miss, or property damage occur?
*
No impact
Near-miss only
Minor injury
Property damage
Multiple impacts
Describe the impact or damage
Follow-up action needed
Please Select
Inspect equipment
Replace equipment
Contact reporter
Document only
Other
Submit Report
Should be Empty: