INCIDENT REPORT (camp & sojourn) Question Title * 1. Site Director Camp All-American Carter, Malcolm Cason, Sky Courtmanche, Kaitlyn Curl, Brent Graham, Bunny Heard, Jennifer Jones, Aladdin Phillips, Isaac Whisenant, Jon Wolfe, Sarah Elizabeth Other (please specify) Question Title * 2. Person Filling out this form Question Title * 3. Group Question Title * 4. Facilitator(s)/Counselor(s) Involved Question Title * 5. Element/Activity Question Title * 6. Participant Type (if applicable) Child Teenager Adult Facilitator N/A Question Title * 7. Type of Incident Unauthorized Access to Course Unclipped at Height Rescue from Height Fall from Height Rope Burn Scrape, Cut, or Abrasion Bump, Bruise, Strain, Sprain Head, Neck, or Back Pain Bloody Nose Other (please specify) Question Title * 8. Description of Incident Question Title * 9. Policy/Procedure(s) Violated to cause incident: Submit