This form is to be completed by party to the accident/incident or witness of the accident/incident occurring on one of the properties owned by Greater Fairview Baptist Church. The details must be completed with as much detail as possible. The information reported will be shared with the parties/persons responsible for the safety of GFBC parishioners. 

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Injured Person Information

Sex(required)

Details of Accident/Incident

Type(required)
Outcome(required)

Witness Information

Form Completed By:

Acknowledgment(required)