New Hope Church

Incident Report Form

Home
Incident Report Form

Incident Report Form

Error

Incident Report Entry

Added: 2/5/2025

Incident Report Form Instructions:

The information you enter will update or create a profile for the person in the church database. If no phone for the person, enter 000-000-0000. If no email for the person, enter fake@gmail.com .

If you are a staff person with New Hope and have a Rock Login, please make sure you are logged out of Rock when you fill out this form.

NOTE: By completing this form, you hereby certify that the information you are providing about this incident is true, correct, and complete to the best of your knowledge and belief.

Entered By:

Entered By: is required.

First Name of person involved/injured:

First Name of person involved/injured: is required.

Last Name of person involved/injured:

Last Name of person involved/injured: is required.

Is the Person Involved Under 18

Yes No

Is the Person Involved Under 18 is required.

Phone of person involved/injured:

Phone of person involved/injured: is required.

Email of person involved/injured:

Email address is not valid

Email of person involved/injured: is required.

Have parents been notified:

Yes No

Have parents been notified: is required.

Affiliation with New Hope:

Staff Member Volunteer Other

Affiliation with New Hope: is required.

Date of Report

Date of Report is required.

Date of incident

Date of incident is required.

Location of incident

Location of incident is required.

Ministry affiliation of person(s) initiating incident (If any):

None Connections Creative Communications Events Finance HR IT New Hope Kids New Hope Students Operations Pastoral Care Production Risk and Safety/ MERTMinistry affiliation of person(s) initiating incident (If any): is required.

Detailed description of incident/injury

Detailed description of incident/injury is required.

Witnesses present (if any):

Witnesses present (if any): is required.

Administrative response taken (If any):

Administrative response taken (If any): is required.

Submit