Injury/Property Damage Report Guide for Michigan 4-H and MSU Extension
DOWNLOADOctober 13, 2026 - Michigan State University Extension
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EmailQuick Reference Guide for Staff & Volunteers
Purpose of This Form
A secure digital tool for reporting any injury, illness, or property damage involving a non-employee during MSU Extension or 4-H programs. All submissions go directly to MSU Risk Management & Insurance (RMI).
Injury/Property Damage Report Form
Who Can Submit
- Volunteers may submit the digital report directly.
- Staff may submit reports on behalf of volunteers, parents, or others.
If you see it, hear about it, or respond to it you can report it.
When a Report is Required
Submit a report as soon as possible after any of the following:
- Injury to a youth, volunteer, parent, or visitor (even minor injuries)
- Illness during a program requiring care or early dismissal
- Property damage during a 4-H or Extension activity
- Any incident that could lead to a claim or concern later
- Emergency responders are called (after calling 911 first)
Do NOT use this form for:
- Employee injuries ---> Workers' Compensation
Information Needed
- Date, time, and location
- Clear description of what happened
- Environmental conditions (weather, surfaces, equipment)
- Actions taken (first aid, EMS, parent contact)
- Names and contact information of those involved
- Supervisor/administrator to notify
- Optional: additional email for county requirements
- Optional: photos or documentation
After You Submit
- The report will route to the 4-H PC entered in the form for their review.
- If they approve, it will automatically route to RMI.
- If they reject, you will need to review with the 4-H PC and a new, revised form will need to be resubmitted.
- Supervisor/administrator receives a copy for review and approval
- RMI may request clarification or additional details
- Staff assist families with American Income Life claims if applicable
Examples of When to Report
- Youth scrapes knee at a club meeting
- Volunteer breaks school equipment
- Camper becomes dizzy/vomits during outdoor activities
- Parent slips on wet grass at an event
- Horse kicks a building causing damage
When in doubt, report. Early documentation protects youth, volunteers, staff, and the program.
Support
MSU Risk Management & Insurance
riskmgmt@msu.edu
517-355-5022
