Gymforms – Thomas College

Please select the form you would like to complete:
Date of the incident:
Date Format: MM slash DD slash YYYY
Staff Name:
First Last
Details of the incident:
Please be direct and specific
Name of Individual Injured:
First Last
Phone
Date
Date Format: MM slash DD slash YYYY
Nature of the Injury:
What part of the body is injured?
What is the extent of the injury:
Minor abrasion, blood spill, contusion, fracture, etc.
Where did the injury occur:
How did the injury occur:
Be specific.
What action was taken to address this injury:
example: basic first aid, called for outside help, etc.
Who was called upon to assist with the injury
- Athletic Center Staff Only
- Professional Staff on Campus
- Public Safety
- Called 911
Name of Person Contacted:
Person Completing Report
- Staff
- Injured
- Coach
Your name:
First Last
Name
First Last
To be completed by the staff on duty and person responsible for damage, if applicable.
Date of Report
Date Format: MM slash DD slash YYYY
Phone
Location of damage:
Date of Damage
Date Format: MM slash DD slash YYYY
Action Followed:
Brief account of nature of the damage:
6:00 a.m. - 9:00 a.m.
- Spray and Wipe Down Dumbbells and bars
9:00 a.m. - 12:00 p.m.
- Clean mats in Lower Plyo Room Pick up Dumbbells in the weight room
12:00 p.m. - 3:00 p.m.
- Spray and wipe down consoles on cardio equipment Pick up Dumbbells in the weight room
3:00 p.m. - 6:00 p.m.
- Spray and wipe down keyboard/phone/front desk
6:00 p.m. - 9:00 p.m.
- Spray and wipe down Vinyl in weight room Pick up Dumbbells in the weight room
Opening Procedure
- Turn on the lobby lights
- Turn on the TV monitors
- Write Daily Activity on the Board
- Unlock the rooms upstairs (Fitness Center, Multipurpose Room)
- Turn on upstairs lights as needed
- Turn on the field house lights as needed
- Turn on downstairs lights in locker rooms
- Check for any set-up instructions left by the Director for a scheduled event today
- Unlock the equipment locker behind the Control Desk
Notes for the Director:
As you walk through the building today please note any damage or areas of concern and leave this note for the Director. Examples: missing ceiling tiles, water damage, broken locker, etc.
Name
First Last
- At 11:45 END all activities, collect equipment – allow people to finish workouts by 11:00
- At 12:00 make sure that all participants have left the building
- Make sure that all equipment (including tables, chairs, scoreboards, ext. cords etc.) had been put away in its proper place (unless task sheet indicates otherwise)
a. Medicine Balls, jump Ropes, and Foam rollers are on the rack in Dance Room
b. 5 TRX bands are hanging in the Boxing room
c. All blue boxes and mats are properly put away in the fitness room
d. Strength belts and writs straps are hanging on coat rack in fitness center
- Lock ALL storage spaces (i.e. closets) in field house, boxing studio, multipurpose room.
- Check the locker rooms for items left behind, collect and log in at Control Desk “Lost-and- Found”.
- Close ALL open windows (Multipurpose room and Boxing room)
- Turn off all of the lights downstairs, including the locker rooms and stairwell
- Once downstairs is secured, turn off field house lights
- Weight Room
a. Wipe down equipment
b. Put weights away
c. Put mats away
- Turn off the lights, TV monitors (Fitness Center, Multipurpose Room, Boxing Studio)
- Make sure that the Control Desk is orderly
- Turn off the toggle sound control in front on Director’s office, and the satellite Radio
- Replace the Work Study keys
- Make sure the equipment locker behind the Control Desk is tidy and locked
- Turn off the lobby lights, computer monitors, and TV’s as you exit for the night.
- Call Public Safety to lock the lobby doors, REMAIN in the building until it is locked
Your Name
First Last
Email*