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Medicine Hat
Rifle and Revolver Club
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Incident Report Form
Incident Date
Incident Time
Range Location:
Nature of incident
Names and details of any person(s) injured
Identify any club property damage (list all)
Report name(s) of offender(s) and/or license plate number(s) or any other form of identification known
Were the police involved
Yes (please include file number
No
File Number
Use a narrative report to describe the incident in detail
Was an RSO present
Yes
No
RSO #
RSO Expiry
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