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MENU
News
Match Day Reports
Season Calendar 2023
Events calendar
About Us
FSC Structure
Board and Football Councils
FSC Staff Structure
Roles and Responsibilities Matrix
Contact & Account Details
Corporate Documents
Annual Year in Review
Constitution
Corporate Brochure
Strategic Plan
Life Members
Sponsors
Unification
DRIBL
TEAM MANAGER Game day Match sheet instructions
Dribl User Guide
Season Calendar 2023
DRIBL – Reporter & Recorder process – Team Manager
Clubs
All Clubs
Club Advertisements
Club Correspondence
Grounds
RESOURCES
All Resources
Club Correspondence
Club Memorandum’s
Injury and Insurance
FSC Policies
Player Registration Fees
Competitions
Season Calendar 2023
Junior Football
Junior Clubs
Junior Strip Clash Matrix
Junior Competition – FAQ and Guides
Women’s Football
Women’s Clubs
Women’s Fixtures & Results
Men’s Premiership
Background to Competition
Men’s Clubs
Men’s Fixtures & Results
Men’s Community League
Men’s Community League Clubs
Summer Football
Junior Summer Football
Senior Summer Football 2022
Team Status
Rules and Regulations
Five A Side Competition
Registration Info. and Guides
Programs
Flare Football
Female Football
South Coast Flame Football Club
Skills Acquisition Program
FNSW Boys Youth League Two
FNSW Girls Youth League One
Sydney FC Fan Development Officer for FSC
Walking Football
Coaching
Upcoming Courses
Coaching Sessions
Mini-Roos Age 5 – 8
Skills Acq Age 9 – 13
Game Training Age 13 – 17
Seniors Age 18+
Player Welfare
Coach & Player Development Articles
FA Development Articles
Global Development Articles
Resources
Referees
Referee Courses
Appointments
Information and Registration – Referees
Uniform and Equipment
MatchRef Start Up
Referee Meetings
Resources
FAQ – Referees
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Reporting an Injury
FSC Injury Report
This form is for reporting an injury from football.
Step 1 of 3
33%
Introduction
This form is to notify Football South Coast of an injury which has occurred at a Football Event.
Reporter's Details
Your Name
*
First
Last
This is the name of the person submitting this form
Email address
*
This is the email address for the person submitting this form
Club Associated with
*
If you are not associated with a club put NA
Reporter's Age
*
Adult (over 18)
High School (12 - 18)
Primary School (6 - 12)
Please choose one of the options
I wish to report an accident/injury which has occurred to
*
Myself
Another Person
My role at the football event was as a
*
Player
Parent
Team Official - (Coach / Manager)
Spectator
Club Official
Match Official (Referee or Assistant Referee)
FSC Offical
Other
Injury Details
Name of person who had the Injury
*
First
Last
Date when the Injury Occurred
*
Date Format: DD slash MM slash YYYY
The injury occurred during
*
Football Training
Football Match
Other Event
Age Group of Match
*
Senior (19+)
U18
U17
U16
U15
U14
U13
U12
U11
U10
U9
U8
U7
U6
Home Team
*
Away Team
*
What was the event?
*
Venue
*
When did the accident or injury occur?
*
Approximate time e.g. 1:30pm or 1st half of match or 2nd half of match
Where did the accident/ injury occur?
*
Was it on the field, sideline, canteen area, seating, ...
How did the accident / injury occur?
*
What were the injuries / suspected injuries?
*
What treatment for injury / injures (if any) was provided and by whom?
Was an ambulance called?
*
Yes
No
Any Additional Information?
Note
This is not a claim form - only a notification to FSC. To commence an insurance claim, you must use the ONLINE - Gow Gates - Personal Injury Claim Form.
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