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 to:email@example.com>. 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.