Report An Incident

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How We Help Proprietors
Our Story
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REPORT AN INCIDENT

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How We Help Proprietors
Our Story
Training
Report An Incident
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Home
How We Help Proprietors
Our Story
Training
Report An Incident
Get a Quote
Customer Login

Report an Incident

Initial Prompt/Login
Injured Party Information

Bowling Center Contact Information

Bowling Center Name

Name and Title of Person Reporting Incident

Best Phone Number to Reach Person Reporting Incident

Bowling Center Address Where Incident Occurred

Address Line 1

City

State

Best Email for Communication With Bowling Center

What date did the incident occur?

Is the date you learned of the incident different than the date it occurred?

Yes

What date did you learn of the incident?

From whom (and how) did you learn of the incident?

Approximately what time did the incident occur?

How many people are injured?

Injured Person Information

Name (if unknown, type “unknown”)

Injured party Phone/Mobile

League Bowler (Y/N)

Approximate Age

Gender

Male

Female

Add another injured person

Yes

Name

Phone/Mobile

League Bowler (Y/N)

Approximate Age

Gender

Male

Female

Add another injured person

Yes

Name

Phone/Mobile

League Bowler (Y/N)

Approximate Age

Gender

Male

Female

What type of incident are you reporting?

Bowling Related Injury – Slip & Fall

Bowling Related Injury – Stick & Fall (with or without crossing foul line)

Non-Bowling Related Injury – Trip & Fall Down Steps

Non-Bowling Related Injury – Trip & Fall Outside

Assault/Fight Incident

Liquor Liability/Drunk Driving Incident

Something Else

What part of the body did the person injure?

What game, frame, and ball did the person fall in?

Was the bowler wearing rental shoes or their own shoes?

Their own shoes

Rental Shoes

Did any staff inspect the shoes after the incident occurred? (Y/N)

Who?

Were photos of the shoe bottoms taken?

Yes

Please upload any photos of rental shoe bottoms prior to submitting this form.

Choose File

Did the person land head first or feet first?

Had the injured party been drinking alcohol?

Yes

Please upload all receipts of drinks sold to injured party prior to submitting this form.

Choose File

What did the injured party say happened?

Who else witnessed it and what do they say happened?

Did you or another staff member inspect the approach and seating areas after the incident occurred?

Yes

Did you observe any substances on the approach?

Yes

Did the injured party track lane conditioner back onto the approach after falling?

Yes

Did you observe any drinks, water bottles, or food on the floor around the seating area?

Yes

Did you take photos of the area?

Yes

Image Upload

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Did the bowler cross the foul line?

Yes

What happened? Please describe the incident with as much detail as possible.

What part of the body did the person injure? Be specific. If the arm, specify which arm and where on the arm, for example.

Please explain, by telling a detailed story, what happened. (Ex: Where were they coming from/going to? Were they going up the steps or down? Did they have anything on their arm or in their hands? Was anyone next to them when they fell? Did their cell phone fall out of their hand? What kind of shoes were they wearing?)

Did the person completing this report witness the fall?

Yes

From what source did the person filling out this report learn about what happened?

Injured party themselves

Injured party’s relatives or a member of their group

Unrelated customers

Another employee

Video surveillance

Please provide name(s) and contact information of relatives or members of injured party’s group, if available.

Please provide name(s) and contact information, if available.

Please provide name and contact information of employee.

File Upload

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Did anyone else witness the fall? If so, who? Please give their name(s) and contact information, if available.

Did you or another staff member inspect the steps after the incident occurred?

Yes

If yes, did you observe any rips, tears, uneven surfaces, or other tripping surfaces on the steps where the person fell?

Yes

If no, please take photos of the steps as they are right now and upload prior to submitting.

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Image Upload

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Where did the person fall?

What was the weather like at the time they fell?

Where did the fight/assault occur?

Please explain, by telling a detailed story, what happened. (Ex: How did the fight start/who started it? Were there any statements made between the parties that were overheard that may have incited the fight? Who threw the first punch?)

Was security on duty?

Yes

Please upload their after-action reports.

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Was anyone directly involved in the fight served alcohol?

Yes

Preserve ALL receipts for any alcohol served to all parties involved, and upload them here.

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Preserve ALL video footage from all public angles from the time any member of the group arrived to the time all parties involved departed, and upload that video here.

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If someone died, call Cameron Linder (559-360-4695) immediately — even if it’s 3:00 AM! Call twice to override Do Not Disturb mode.

How did you learn about the incident?

Do any staff remember serving the driver involved in the accident?

Was the driver ever cut off from being served alcohol?

Preserve ALL receipts for any alcohol served to all parties involved, and upload them here.

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Preserve ALL video footage from all public angles from the time the driver involved arrived to the time they departed, and upload that video here.

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Please call Cameron Linder (559-360-4695) during the next business day to discuss further actions.

Please upload video, photos, statements, and any other relevant information

File Upload