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MENU
News
Match Day Reports
Season Calendar 2024
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
Clubs
Our Clubs
Club Advertisements
Club Changer Development Program
Club Communication Info and Memos
Grounds
Coaching
Session Plans
Mini-Roos Age 5 – 8
Skills Acq Age 9 – 13
Game Training Age 13 – 17
Seniors Age 18+
Upcoming Courses
Player Welfare
Resources
Coach & Player Development Articles
FA Development Articles
Global Development Articles
Competitions
Winter Football
Men’s Premiership
Women’s Premiership
Junior Competition
Men’s Community League
Women’s Community Competition
Player Registration Fees
Registration Info. and Guides
Season Calendar 2024
Summer Football
Junior Summer Six’s
Rules and Regulations
Senior Summer Football
Team Status
Five A Side Competitions
Monday – Mixed Comp
Tuesday – Men’s Social Comp
Wednesday – All Age Women and O40s
Thursday – Mens O40s Comp
DRIBL
User Guide for Team Official – Match Sheet
Dribl Match Sheet Issues
Programs
Female Football – Whats On?
Female Football Week
Flare Football
Sydney FC Programs
South Coast Flame Football Club
FNSW Boys Youth League Two
FNSW Girls Youth League One
Skills Acquisition Program
Walking Football
Referees
Upcoming Courses
Education and Development
FAQ – Referees
Information and Registration
Weekly Appointments
Resources
RESOURCES
Codes of Conduct
Competition – Rules, Forms and Policies
Disciplinary and Disputes
FSC Policies
Insurance, Sanctioning
Member Protection
Policies and Guides
Codes of Conduct
Courses and Training
Working With Children Checks
Help for Kids
Complaints Handling
Member Protection Officer
Online Safety
Synthetic Pitch
Signage Opportunities
Synthetic Pitch Hire
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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