Guest Incident Report

Use this form to report any guest or patron accidents, injuries, medical situations, suspected criminal activities, and/or behavioral incidents that take place on company grounds. If possible, this form should be submitted in real time or, at minimum, completed within 24 hours of the event.

"*" indicates required fields

Location*

Select a locationAthens, OhioBullhead City, ArizonaCanal Winchester, OhioFlagstaff, ArizonaHeath, OhioLancaster, OhioMt. Vernon, OhioNew Philadelphia, OhioPrescott Valley, ArizonaTaylor Square, Ohio

Date of Incident*

MonthMonth123456789101112

DayDay12345678910111213141516171819202122232425262728293031

YearYear20262025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920

Time of Incident

Hours

:

Minutes

AM PM AM/PM

Your Name*

First Last

Your Email*

Your Phone Number*

Description of Incident*

Description of Injury

Names & Phone Numbers of Witnesses (If applicable)

Please upload any supporting documentation

Drop files here or Select files

Max. file size: 128 MB.

Signature*

By signing, I certify that all information provided is true and correct to the best of my knowledge.

Submit