| Date of Incident | Time of Incident: | Location in Park: | Weather Conditions: | First | Last | Age: | Grade/Class: | Parent/Guardian Contacted Y/N: | First | Last | Incident Description | What Happened: | Witnesses: | Injury Details | Injured Body Part(s) | Type of Injury: | Detail Other | Medical Attention Required | Choices | Details: | follow-up | Reported By | Name: | Position: | Date | Park Lead Name: | Date |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 10/24/2025 | 03:30 PM | Mega slide | cloudy, dry, cool | John | Doe | 12 | 5 | y | Jane | Doe | Went down head first. Scrubbed his face in the sand at the bottom of the slide | Betty | face |
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| none | none | Albert Pear | play ground manager | 10/24/2025 | This is a test of this form by Roger. ONLY A TEST | 10/28/2025 | |||||
| 11/02/2025 | 11:15 AM | Bounce Pillow | Clear | Carter | Cherry | 2.5 | 0 | Y | Robert | Cherry | The father Robert Cherry said he did not see the incident happen, but he assumes that his son got double bounced on the pillow and hyperextended his left knee. Phone# (248) 925-6526 | None | Left knee |
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| We gave an ice pack for the knee. The father said that he is putting some weight on it, but will be taking him to urgent care to have it checked out. | Not sure father‘s phone number is listed | Sherri Davis | Silo Worker | 11/02/2025 | Sarah | 11/02/2025 | |||||
| 11/07/2025 | 01:25 PM | Corn Pit | Sunny | Emmett | Buckner | 9 | 3 | Y | Ann | Austin | Corn got stuck in child's ear. | Sarah, Peyton, and Mattie | Ear |
| Mom's number, 803-622-0225 |
| After failed attempt, it was recommended for the child be taken to the doctor for further assistance. | None | Tiffany Mullen | Silo/Medic | 11/07/2025 | Angela Mullen | 11/07/2025 | ||||
| 04/04/2026 | 12:45 PM | Rocking tube | Clear | Scarlet | Horne | 7 | 1 | Y | Derrick | Horne | She was on the swinging tube. She fell out. It came back, hit her in the face bruise the side of her right side of her face. She lost a tooth and hit her arm. | Her father | Right side face, head, and arm. Hit in the mouth lost and lost a tooth |
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| Gave an ice pack and some bandages. | None yet | SherriDavis | Silo | 04/04/2026 | Sara | 04/04/2026 | |||||
| 04/08/2026 | 11:37 AM | Pirate ship | Clear windy | Liam | Garrett | 6 | 1 | Y | Ashley | Garrett | Ran into the crossbar on the ship | Family, mom | Hit mouth |
| Busted mouth |
| Na | Sarah | Park lead | 04/08/2026 | Sarah walzer | 04/08/2026 | |||||
| 04/09/2026 | 03:20 PM | Parking lot | Sunny | Jahlaiya | Simon | 1 | 0 | Y | Alaysianna | Wright | Toddler fell out of the wagon getting out of the wagon | Mom | Hit head on rocks |
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| Ba | Sarah | Park lead | 04/09/2026 | Sarah | 04/09/2026 | ||||||
| 04/11/2026 | 11:37 AM | Corn pit | Sunny | Zabiame | Townsend | 5 | K | Y | Keisha | Simon | Child was playing in the corn pit and got a piece of corn stuck in his ear | Parent | Ear |
| Corn stuck in ear |
| Na | Sarah | Park lead | 04/11/2026 | Sarah Walzer | 04/11/2026 | |||||
| 04/19/2026 | 03:43 PM | Mt slide | Overcast | Sierra | Russell | 38 | N/a | Y | Sierra | russell | I hit my foot on the side of the slide | Hillery Fulton and Lacosha Washington | Ankle |
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| N/a | Sarah | Park lead | 04/19/2026 | Sarah walzer | 04/19/2026 | ||||||
| 04/23/2026 | 11:10 AM | Mega slide | Sunny | Akiya | Burgess | 7 | 1 | N | Sincere | Burgess | Child went down the mega slide when she got to the end the tube tipped over, causing injury to the wrist and carpet burn to the head. | Shelby Griffin (Chaperone) | Wrist/Head |
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| N/A | Tiffany Mullen | First Aid | 04/23/2026 | Angela Mullen | 04/23/2026 | ||||||
| 04/26/2026 | Mega slide | Cloudy | Bodie | Hoover | 8 | 2 | Y | Walton | Crawford | As he was coming down the small slide, it flipped over at the bottom and he got road rash on his face and right arm. | Mother (803) 730-2875 | Right side of face at the eye. Right wrist and hand |
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| Not sure | Sherri Davis | Silo | 04/26/2026 | Sarah | 04/26/2026 | |||||||
| 05/15/2026 | 01:09 PM | Tunnel Slides | Sunny | Jiovani | Franco | 14 | 8 | Y | Maribel | Felix | Child was sliding down. The tunnel slides from the top of his head, scrape the top of the side. | Mother | Head |
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| Mother was told if further symptoms arise to take child to urgent care or emergency room. | None | Tiffany Jasmin Mullen | First Aid | 05/15/2026 | Angela Mullen | 05/15/2026 | |||||
| 05/15/2026 | 01:09 PM | Tunnel Slides | Sunny | Jiovani | Franco | 14 | 8 | Y | Maribel | Felix | Child was sliding down. The tunnel slides from the top of his head, scrape the top of the side. | Mother | Head |
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| Mother was told if further symptoms arise to take child to urgent care or emergency room. | None | Tiffany Jasmin Mullen | First Aid | 05/15/2026 | Angela Mullen | 05/15/2026 | |||||
| 05/16/2026 | Playground | Hot sunny | Jamie | Silva | 36 | Na | Na | Jamie | Silva | Dehydration/ heat exhaustion due to IBS | Cindi witnesses | Na |
| Heat exhaustion |
| Advised medical attention | Sarah | Park lead | 05/16/2026 | Sarah walzer | 05/16/2026 | ||||||
| 05/17/2026 | 04:05 PM | Entrance near fountain area | Sunny hot | Crystal | Haas | 36 | N/a | Y | Crystal | Haas | Crystal was responding the to emergency involving her friend; Jamie Silva when she crossed over a barrier into an unauthorized area near the fountain pump. When doing so she lost her footing and tripped on one of the pumps control panels located in the ground on the fountain side of the barrier fencing in front of the Do Not Enter sign. When Cottle staff was notified of her injury, she was taken to the already responding and present EMTs where Jamie Silva was being treated. Crystal initially declined medical treatment but accepted an ice pack given by Cottle staff. Moments later after she spoke with Jamie; she then agreed with Cottle staff and had the paramedics look at her ankle. They wrapped her ankle to secure the ice pack given by Cottle staff. Upon leaving the farm, Crystal was asked how her ankle was and she said that she was fine that there was no pain. | Sarah walzer | Ankle |
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| Na | Sarah Walzer | Park lead | 05/17/2026 | Sarah Walzer | 05/17/2026 | ||||||
| 05/30/2026 | 04:23 PM | Mega slide | Overcast/sunny | Paisley | Putoff | 36 | 0 | Y | Adam | Mathis | On the slide and collided with own child at the bottom. Child didn’t move out of the way in time. Dad wasn’t paying attention to the child. | Adam mathis | Head injury, eye socket was swollen and turning black |
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| Given ice pack to swollen eye absolutely did not want an ambulance called | None | Sarah | Lead | 05/30/2026 | Sarah | 05/30/2026 | |||||
| 06/05/2026 | 11:55 AM | Train | Sunny | Brady | Hallier | 6 | 1 | Y | Tara | Hallier | Kyle was running to a cart on the train and tripped and fell and hit his head. | Bobby | Head |
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| Teacher that symptoms get worse or nausea or taking this happens to take him to the emergency room | Tiffany Mullen | First Aid | 06/05/2026 | Angela Mullen | 06/05/2026 | ||||||
| 06/05/2026 | 11:55 AM | Train | Sunny | Brady | Hallier | 6 | 1 | Y | Tara | Hallier | The child was running to the back of the train racing with a friend when he tripped and fell and hit his head on a rock. | Bobby | Head |
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| Ice pack was placed on the boys head and then a cognitive test was administered. | Teacher and child were informed if he starts feeling nauseous or dizzy to immediately tell his teachers so that he can be taken to the hospital or a doctor. | Tiffany Mullen | First Aid | 06/05/2026 | Angela Mullen | ||||||
| Date of Incident | Time of Incident: | Location in Park: | Weather Conditions: | First | Last | Age: | Grade/Class: | Parent/Guardian Contacted Y/N: | First | Last | Incident Description | What Happened: | Witnesses: | Injury Details | Injured Body Part(s) | Type of Injury: | Detail Other | Medical Attention Required | Choices | Details: | follow-up | Reported By | Name: | Position: | Date | Park Lead Name: | Date |




