TWINKLE STARS

EARLY CHILDHOOD EDUCATION CENTRE

INCIDENT REPORT

Child’s name : ______________________ Date : ______ / ________ / ________

Time of incident : ________________________ am / pm

Description of incident : _____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
First aid given : _____________________________________________________________________
Location of incident : _____________________________________________________________________

Teacher’s signature: Principal’s signature

_____________________ _____________________

Notification acknowledged by : Parent’s signature / Date

________________ / ________________

TWINKLE STARS
EARLY CHILDHOOD EDUCATION CENTRE

INCIDENT REPORT

Child’s name : ______________________ Date : ______ / ________ / ________

Time of incident : ________________________ am / pm

Description of incident : _____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
First aid given : _____________________________________________________________________
Location of incident : _____________________________________________________________________

Teacher’s signature: Principal’s signature

_____________________ _____________________

Notification acknowledged by : Parent’s signature / Date

________________ / ________________