Accident Reporting
Accident Reporting Procedures
What to report: An incident that causes any player, manager, coach, umpire, or volunteer to receive medical treatment and/or first aid must be reported to the Safety Officer. This includes the evaluation of the extent of the injury.

When to report: All such incidents described above must be reported to the Safety Officer within 24-48 hours of the incident. The Safety Officer is Jason Goldberg. He can be reached several ways:

Home: (973) 835-2724

Cell: (973) 906-8092


How to make the report: Coaches MUST Complete the online Accident/ incident report. Please fill out the Form to the best of your ability and save a copy to your local PC when complete. Then, email this document as an attachment to Jason Goldberg at mail>.  I would prefer to have the coach or league official complete the accident form in your own words.  At a minimum, the following information must be provided:· The name and number of the individual involved.

· The team and league of the injured player.

· The date, time, and location of the incident.

· As detailed a description of the incident as possible.

· The preliminary estimation of the extent of any injuries.

· What type of treatment was given by you or others?

· The name and phone number of the person reporting the incident.

Safety Officer’s Responsibilities: Within 24-48 hours of receiving the incident report, the Director of Safety will contact the injured person or his/her parents and:

(1) verify the information received;

(2) obtain any other information deemed necessary;

(3) check on the status of the injured party; and

(4) In the event that the injured party required advanced medical treatment (i.e., Emergency Room visit, doctor’s visit, etc.) I will advise the parent or guardian of the Pequannock Little League’s insurance coverages and the provisions for submitting any claims.

If the extent of the injury is more than minor in nature, the Safety Officer may periodically call the injured party to check on the status of the injury and the well being of the athlete. The Safety Officer will also check if any other assistance is necessary, such as submission of insurance forms, etc. until such time as the incident is considered “closed” (i.e., no further claims are expected and/ or the individual is participating in the league again).
Thank you.