Jetpack Adventures
Incident Reports- New Record

  • Incident Name
  • Injury Type
  • Operator
  • Weather
  • Incidents/Injury Report

INCIDENT/INJURY REPORT ENTRY

    Employee    Contractor    Pilot   
       Near Miss       Injury

Details of Injured Person

      
  
Male    Female

Details of Incident

 

DETAILS OF WITNESS

NAME
PHONE:
Address

Details of Injury

Treatment Administered

  YES    NO

OPERATOR



JETPACK UNIT


        YES    NO

INSTRUCTOR COMMENTS


WEATHER


    GOOD    MID    BAD    RAIN    WIND

RECORDS


     YES     NO
     YES     NO

HOW DO YOU MITIGATE THE CHANCE OF THIS INJURY OR INCIDENT