You will receive a copy of your submission at this email
Example: ###-###-####
If under 18 years old
Player, Umpire, Coach, Other (describe)
Parent/Guardian if Injured Party is under 18 years old
Parent/Guardian if Injured Party under 18 years old
Please provide as much detail as possible
Include which Diamond and specific location (eg. Little League Park - Major Diamond - Home Plate)
Please be as specific as possible on the details surrounding the incident
Eg. Right Leg Laceration, Possible Concussion
Skip section if injury if not a head injury
Check all that apply
include if not Reporting Individual or Parent/Guardian named above (xxx-xxx-xxxx)
include if not Reporting Individual or Parent/Guardian named above