Volunteer & Mentor Resources

Incident Report Form

Report and document any incident promptly. When in doubt, report it. This form goes directly to Dazzling G.E.M.S. leadership. If a child is in immediate danger, call 911 first.

If a child is in immediate danger, call 911 first. Then return to this form to document what happened.

Reporter Information

Incident Details

Follow Up

Was anyone injured? *
Was a parent or guardian notified? *

Reporter Signature