Accident and Incident Report
What constitutes the requirements for
the submission of accident and incident report:
Any time a driver is NOT able to
continue to race and/or transported to a medical facility. Also, anytime
that a person is injured to the point
of needing the assistance or support of medical personnel.
Example 1 – a driver is involved in a
wreck during a race and injures his elbow. If the driver is
unable to continue the race due to the
Example 2 – A handler trips and falls
in the hot chute and requires medical attention.
Example 3 – A child falls at the
playground and cuts his hands and requires medical
Where to Find Forms and Get Further
‐ All forms are located on the QMA
Website, under the Documents section.
‐ If you need
assistance, contact the QMA National Secretary.
‐ All QMA Club
Officers and Regional Officers will be able to assist. See the QMA website or
current Rule book for
phone numbers and email addresses.
Procedures for completing and
1. All forms must be completed and submitted to the QMA National Secretary
(firstname.lastname@example.org) within 48 hours of the incident or accident
(if you cannot send them within 48 hours, please contact the secretary within
that time to let him/her know about the accident). Copies must also be sent to the Regional
2. The club Safety Director or club
officer should complete the QMA Incident Report and the front of the K & K Oval
Accident Report. The remaining pages should be completed by Handler/Parent of
3. When the forms are received by the
QMA National Secretary, membership will be verified, documented and submitted to K & K
‐ K&K is a secondary insurance,
the member’s medical insurance will be primary or first payee, any
remaining deductibles would be covered
by K & K.
‐ Claims not submitted completed to
QMA and K&K within 30 days may not be covered.
‐ Any questions please contact the QMA
‐ All Sign‐in sheets, safety sheets,
waivers (1068, 1069, etc.) must be kept on file at the club level
for at least one year (suggested time
frame is 3 years). Your state’s laws may require
that you keep these longer – sometimes up to 7 years.
Any injury to a spectator (non QMA
member) the above procedures MUST be followed, within 24 hours.
All forms are located at
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