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EQUIPMENT DAMAGE REPORT FORM
Spring 2009
Directions: 1. Fill out all four steps
2. Deliver to Coach or any Board member
1. Name of shell: ___________________________________
2. Check the appropriate box. If item is NOT listed, skip to step 3 to write in.
[ ] Cracked outside hull [ ] Broken skeg or rudder
[ ] Cracked inside hull [ ] Shoes torn or worn out
[ ] Taking on water [ ] Any missing/damaged parts
[ ] Bent or broken rigger [ ] Loose/damaged seat or track
[ ] Cox box wiring does not work [ ] Loose/damaged foot stretcher
[ ] Damaged oarlock
3. Describe the DETAILS and SPECIFIC LOCATION of the damage:
4. Name: ___________________________________
Phone No.: _______________________________
E-mail: __________________________________
Date of damage: __________________________
Time of damage: __________________________
* This information is used to monitor the equipment and expedite necessary repairs and
maintenance. Thank you.