The purpose of the AYSO Incident Report Form is to capture all pertinent facts and contact information, while the information is readily available, whenever there is a serious incident involving AYSO participants, activities, facilities or property.

When to file an Incident Report form?

Incident report forms should be completed by any coach, referee or Regional staff member witnessing any serious incident involving, but not limited to:

• Injury
• Threats of bodily harm
• Fighting whether or not a serious injury occurs
• Property damage
• Hospitalization of a participant
• Law enforcement summoned
• Service or notification of a pending lawsuit

Send the completed Incident Report to:

Safety and Risk Management Director
Ross Paulson
2515 Canada Blvd.
Glendale CA 91208
Email: [email protected]