Download the WBPI Incident Report or fill in the form below. If you are a human and are seeing this field, please leave it blank. Fields marked with an * are required Incident Report PERSONAL AND CONFIDENTIAL INFORMATION OF THE BOWL ONLY Name of Bowl * Date of Incident * Approx Time * Bowl Phone Number * Bowl Contact Person Reported by Signature Injured Party’s Name * Age Male or Female * MaleFemale Injured Party’s Phone Number * Work Cell Mailing Address City * Zip League Bowler? YesNo Alcohol Involved? * YesNo Non-Bowling Injury? YesNo What kind of shoes was the injured party wearing? * Rented Bowling ShoesTheir Own Bowling ShoesStreet ShoesSocks onlySandalsNo ShoesOther If a bowling injury, in what frame and ball were they injured? (ex: first frame, second ball) Part of the body injured * What caused incident * Witness Name Witness Phone Related to Injured Person? YesNo Witness Name Witness Phone Related to Injured Person? YesNo Was Medical Attention Needed? * YesNo Paramedics? YesNo Went to Hospital? YesNo Medical attention provided by bowl Injured party continue to bowl? * YesNo Do you think a claim will be made? * YesNoUnknown Did injured party say they had medical insurance? * YesNo Name of carrier IMPORTANT Injured party’s attitude * FriendlyMadThreateningCalmScaredDemanding Explain in detail *