USA Triathlon
Report an Incident

If you are aware of an incident that may give rise to a liability claim under this policy, you are required to report this information immediately using this form.

Event Name

Date of Incident

Time of Incident

Participant Accident Incident

Check this box to complete this section if a participant, spectator or volunteer was injured during this event.

General Liability Incident

Check this box to complete this section if a third party was injured or had property damage sustained during this event.

Injured Party's Information

Injured Party's First Name

Injured Party's Last Name

Injured Party's Phone Number

Phone

Injured Party's Email Address

Type of Event Where the Incident Occurred

USA Triathlon Sanctioned Event

IRONMAN - USA Triathlon Sanctioned Event

USA Triathlon Official Club Event

USA Triathlon Sanctioned Clinic

Team USA International Event

Witness Information

Did you obtain contact information for any witnesses?

Contact Information of Individual Reporting Incident

Name of Individual Reporting Incident

Phone Number of Individual Reporting Incident

Phone

Email Address of Individual Reporting Incident

Race Director Information

Race Director's Name

Race Director's Phone Number

Phone

Race Director's Email Address

File Upload

(Any reports, photos, estimates, etc may be attached to this record)

Drop your files here

Acknowledgement of Individual Reporting Incident

I hereby warrant that the foregoing is true and correct based on my knowledge of the incident by entering my name in the box below.

Send me a copy of my responses

Report Abuse

USA TriathlonReport an Incident

Participant Accident Incident

General Liability Incident

Injured Party's Information

Witness Information

Contact Information of Individual Reporting Incident

Race Director Information

File Upload

USA Triathlon
Report an Incident