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AYSO Region 418 Chicago Lakefront

Incident Report Form

AYSO Incident Report Form Instructions

Note: This form should NOT be completed by a parent unless the parent is the coach.

The AYSO Incident Report Form must be completed by the coach in the event of any serious incident occurring at a practice or game involving, but not limited to:

• Injuries
• Illnesses
• 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

Click the link below to download the form. Submit the completed form to the Region 418 Safety Director, Luke Perez, at [email protected]

AYSO Incident Report Form

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AYSO Region 418 - Chicago Lakefront

4507 N Ravenswood Ave, Suite 101
Chicago, Illinois 60640

Email Us: [email protected]
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