2. City of Parkland Parks & Recreation Department Incident Report
4. Date and Time:*
   Date and Time:

   Date and Time:
5. Location:*
7. BSO Case #:
8. Fire/Rescue Run #:
12. Incident Type:*

    1. Injury
    2. Vandalism/Damage
    3. Disturbance

    1. Dog/ Animal Issue
    2. Other
13. Explain Other:
17. Persons Involved:

    (Person Code: V-VICTIM  R-REPORTEE  W-WITNESS  I-INJURED  O-OTHER)

19. Person 1: Code
20. Select Adult or Juvenile:

    1. Adult
    2. Juv
21. Name:
23. Address:
24. Phone#:
28. Person 2: Code
29. Select Adult or Juvenile:

    1. Adult
    2. Juv
30. Name:
32. Address:
33. Phone#:
37. Person 3: Code
38. Select Adult or Juvenile:

    1. Adult
    2. Juv
39. Name:
41. Address:
42. Phone#:
46. Narrative:*
48. Staff Reporting:*
49. Date:*
    Date:
51. Reviewing Supervisor:*
52. Date:*
    Date:
54. Narrative Continued:
Leave This Blank:


56. 1. Receive an email copy of this form.
57. Email address

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58. Submit

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