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REGISTER FOR TUMBLING CLASSES
Fall Showcase
MENU
Programs
Cheerleading
Preschool
Private Lessons
Special Needs Adaptive Program
0 – 3 Year Old Programs
3 – 5 Year Old Programs
6+ Year Old Tumbling Programs
School Teams
Rise Up Leadership
Events
Birthday Parties
Field Trip
Camps & Clinics
Open Gym
Daytime Playtime
Gym Rental
Helpful Links
Proshop
Subscription Program
Financial Assistance
Customer Portal
Waiver
Job Postings
Donation Requests
Core Values
Membership Cancellation
Forms
Forms
SELECT THE FORM YOU WOULD LIKE TO COMPLETE
MAINTENANCE REQUEST
INCIDENT REPORT
Incident Report
This form should be filled out if any type of first aid has been performed (anything more than give a bandaid)
What location are you filling this out for?
(Required)
Bonnyville
Fort McMurray
Red Deer
Did the the athlete sustain a head injury?
(Required)
Yes - View the attached PDF for more information on how to manage head injuries
No
Patient Information
Please enter information for the person receiving First Aid Treatment
Patients Name
(Required)
First
Last
Birthdate
(Required)
MM slash DD slash YYYY
Known Medical Conditions/Allergies/Medication
(Required)
Patient (or Guardian) Phone Number
(Required)
Parent (or Guardian) Email
(Required)
Incident Information
Please enter all information regarding the incident
Date of Incident
(Required)
MM slash DD slash YYYY
Time of Incident
(Required)
Hours
:
Minutes
AM
PM
AM/PM
Time of First Intervention
(Required)
Hours
:
Minutes
AM
PM
AM/PM
Time of Medical Support Arrival (if applicable)
Hours
:
Minutes
AM
PM
AM/PM
Did a head injury occur
(Required)
Yes
No
Charge Person - Describe the Incident (What took place, Where it took place, What were the signs and symptoms of the Patient)
(Required)
Event and Conditions (what was the event during which the incident took place - example: practice, showcase etc., location of incident - where in the gym? etc, surface quality - example lighting, spills, etc.)
(Required)
Actions taken/intervention
(Required)
After treatment, the patient was:
(Required)
Sent home
Sent to hospital
Returned to sport
Other
Charge Person Information
Name of the person providing first aid
(Required)
First
Last
Phone Number
(Required)
ROLE (Coach, assistant, parent, official, bystander, therapist):
(Required)
Witness Information
Someone who observed the incident and response, not the charge person
Name
(Required)
First
Last
Form Completed By
Please enter the information for whomever is filling out this form
Name
(Required)
First
Last
What location are you requesting this for?
(Required)
Bonnyville
Fort McMurray
Red Deer
Name
(Required)
First
Last
Urgency
(Required)
Emergency (Needs to be fixed ASAP)
Semi-Emergency (next 1-3 days)
Not Too Bad (next 7 days)
Title of the Job
(Required)
Item or area of the gym:
(Required)
What needs to be done?
(Required)
Please use as much detail as possible.
Images
Include any images of what or where you'd like the maintenance completed.
Drop files here or
Select files
Max. file size: 50 MB, Max. files: 5.
Participation Waiver
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