PCA Steward - KCRPCA

Steward Incident Report

Steward Incident Report

Search For: Event Date, Driver's Name, and Time

Date

First Name

Last Name

Time

Driver Information

Information in this section is populated from the Driver's Incident Report

Driver's First Name

Driver's Last Name

Email

Phone

Car Number

Class

Video in Car

Driver Hurt/Soft Tissue Damage

Track Information

Information in this section is populated from the Driver's Incident Report

Track

Date

Time

Session 1

Session 2

Session 3

Track Condition

Corner Number

Flag

Driver's Incident Information

Information in this section is populated from the Driver's Incident Report

# of Cars Involved

Car Left on Course

Car Hit Barricade

Metal to Metal

Rub Out

Mechanical Failure

Drivers Account of Incident

Driver Signature

Scrutinerre's Incident Information

Information in this section is populated from the Scrutinerre's Incident Report

Was there Mechanical Damage

Level of Damage

Scrutineers Account of Incident

Scrutineer's Name

Scrutineer's Signature

Steward's Report

# of Cars Involved *

Car Left on Course *

Yes

No

Car Hit Barricade *

Yes

No

Metal to Metal *

Yes

No

Rub Out *

Yes

No

Mechanical Failure *

Yes

No

Probation Given *

Yes

No

Allowed to Continue *

Yes

No

Already on Probation *

Yes

No

Orientation Meeting Required *

Yes

No

Steward Account of Incident *

Steward's Name

Steward Signature

If you are human, leave this field blank.

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