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TXSNOW Incident Report — Instructor
TXSNOW Incident Report — Instructor
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Date and time of Incident ：
*
Date
Time
Resort：
*
Difficulty：
*
--- Select an option ---
Green
Blue
Black
Minutes into Lesson：
*
Minutes
Run：
*
Location on Hill：
*
--- Select an option ---
Top
Mid-slope
Base
Lesson Information
Discipline：
*
--- Select an option ---
Snowboard
Ski
Duty Status:
*
--- Select an option ---
On duty
Off duty / bystander
Lesson Type：
*
--- Select an option ---
1:1
2:4
Snow Buddies
KM（ Kids Master）
Other
Were you responsible for multiple participants at the same time?
*
--- Select an option ---
No
Yes (please specify in “Other Participant Arrangements”).
Other：
*
Incident Category
Severity：
*
--- Select an option ---
Minor (No Rescue Required)
Moderate (Patrol Involved)
Major (Medical Transport / Lesson Suspended)
Type（check all that apply）：
Fall
Collision (person-person)
Collision (person-object)
Lost/Separated
Equipment malfunction
Weather/Visibility
Medical
Behaviour/Discipline
Other
Other ：
*
Environment & Conditions
• Weather/Visibility：
*
Snow Surface：
*
Crowding Level::
*
--- Select an option ---
Low
Medium
High
Equipment Check：
*
--- Select an option ---
Pre-lesson
Mid-lesson
High
Temp/Wind：
*
Issue Identified:
*
Please describe:
Teaching Context Prior to the Incident
Actions / activities immediately prior to the incident:
*
For example: turn demonstration / straight run / stationary stop / loading the lift / unloading the lift; perceived slope gradient and speed.
Please provide an objective, chronological description:
*
Including verbal instructions, meeting points, and visibility and spacing management.
Injury Details and Immediate Actions (Instructor)
Primary injured area:
*
Actions Taken:
*
Securing the area / warming / immobilization / bleeding control / load reduction
Did the incident affect the Instructor’s ability to continue working?
*
--- Select an option ---
No (no lesson time lost).
Yes
Leave Required:
*
Hours/Days
Estimated return-to-work date:
*
External Communications
Ski Patrol：
*
--- Select an option ---
No
Yes
Time of arrival:
*
Witness name:
*
Case number:
*
Witness contact information:
*
Was medical transport / emergency care required?
*
--- Select an option ---
No
Yes
Hospital/Method:
*
Other Participant Arrangements (if multiple participants were under your supervision at the time):
Arrangement Method:
*
Escorted handover / Waiting at the nearest meeting point / Transferred to a peer Instructor / Dismissed
Communication Log:
*
With the participant / guardian / on-duty staff
Evidence & Privacy
Privacy Statement: This report is used solely for safety and compliance record-keeping and is handled in accordance with PIPEDA’s minimum-necessary principle.
Upload on-site photos/videos:
*
Drag & Drop Files,
Choose Files to Upload
You can upload up to 50 files.
Capture only the environment, safety measures, and equipment placement; avoid nudity or close-up facial images.
Signatures and Acknowledgement
Instructor name：
*
Phone
*
Signature
*
Clear Signature
Instructor ID：
*
Email
*
Date：
*
Submit the form
