Guest Incident Report

Please sign if the person involved with the incident is an adult: By signing this, I have told everything based on the facts and understand that giving false information can disadvantage and worsen the situation.

Parent/s or Guardian Siganture : By signing this, I have told everything based on the facts and understand that giving false information can disadvantage and worsen the situation.

Witness Signature : By signing this, I have told everything based on the facts and understand that giving false information can disadvantage and worsen the situation.

KIDS CITY HAWAII
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KIDS CITY Guest Accident/ Incident Report

INFORMATION ABOUT PERSON INVOLVED IN THE INCIDENT

INFORMATION ABOUT THE INCIDENT

ANSWER IF THE PERSON INVOLVED WITH THE INCIDENT IS A MINOR

INFORMATION ABOUT WITNESS (If Any)

REPORTING STAFF

MANAGER / SUPERVISOR ON DUTY