This is the OLD version of the Northshield web site, please use the
new one
as this information IS outdated!
Home
>
Officers
>
Chirurgeon
>
Event Report
|
Calendar
|
Royalty
|
Great Officers
|
Groups
|
What is the SCA
|
Site Map
|
Chirurgeonate Event Online Report Form
This form will be submitted to the Kingdom Chirurgeon.
Personal Information:
Legal Name:
SCA Name:
Address:
City,St,Zip:
Phone:
Email Address:
Event Name:
Date:
Weather:
Terrain:
Event Steward:
Hosting Group:
(Please select)
Not Listed
Border Downs
\n
Brandon Maitoba
\n
Caer Anterth Mawr
\n
Castel Rouge
\n
Coille Stoirmeil
\n
Coldedernhale
\n
Darkstone
\n
Dreibrucken
\n
Falcon's Keep
\n
Inner Sea
\n
Jararvellir
\n
Ketillblaster
\n
Korsväg
\n
Lub Siochail
\n
Mare Amethystinum
\n
Midewinde
\n
Mistig Waetru
\n
Noiregarde
\n
Nordleigh
\n
Nordskogen
\n
Northshield
\n
Orlova Dolina
\n
Oubliette
\n
Phelps
\n
Raven's Moor
\n
Rivenwood Tower
\n
Rockhaven
\n
Rockwall
\n
Rokeclif
\n
Rudivale
\n
Schattentor
\n
Shattered Oak
\n
Silfren Mere
\n
Skerjastrond
\n
Stromfels
\n
Svatý Sebesta
\n
Tor Aerie
\n
Trewint
\n
Turm an dem See
\n
Vilku Urvas
\n
Western Keep
\n
Windhaven
\n
Wulfhomm
\n
Wynandremer
\n
Not Listed
Other:
Chirurgeon in Charge:
Other Warranted Chirurgeons:
Apprentice Chirurgeons:
Total Attendance:
Martial activites at this event and number of participants each (Check all that apply):
Heavy -
Rapier -
Equestrian -
Archery -
Thrown Weapons -
Really, Absolutely nothing happened.
Well, almost nothing happened
Something interesting happened.
Incident Description: (On site paperwork detailing this incident needs to be sent to the Kingdom Chirurgeon.)
Check off all that apply:
No medical intervention needed
EMTs or paramedics were called
Someone was recommended or sent to a hospital or clinic (including urgent care) from site
A formal referral was made to an on-site or off-site MD
A minor was involved
**These incidents must be reported directly to the Kingdom Chirurgeon within 24 hours
whether or not the person actually follows through with medical intervention
.**
Heavy
Fencing
Equestrian
Archery
Thrown
Weapons
Kitchen
Dance
Other
Gave out some Band-Aids
Gave out some ice
Fluid and rest
Bumps and scrapes
T L C
Sunscreen/Sunburn lotion