Medical Release Form
GLL 2024 ASAP Safety Plan
Injury Reporting Form
Georgetown Little Injury & Reporting Procedure
● A binder with GLL ASAP Safety Plan & all incident reporting forms will be kept in the back of the
concession stand.
● This procedure will be included as part of every division's rules sheet, it will be emailed out to every
parent /guardian prior to the start of the season, it will be posted on the GLL website and it will be
posted outside the concession stand.
● All Managers and Coaches will get a copy of the ASAP Safety Plan.
● All Managers and Coaches must know the GLL Injury & Reporting Procedure.
● All Managers will be required to have completed Medical Release Forms for all players with them at
all practices and games - hard or digital copy.
● If an injury occurs during practice, the Manager or Coach must contact the Safety Officer, President,
VP of Baseball or VP of Softball and report the incident.
● The first to respond will fill out the Incident Tracking Report and email a copy to the Safety Officer, if
not the Safety Officer.
● If an injury occurs during a game, the Manager or Coach must find the Field Director on duty and
report the incident.
● The Field Director on duty will fill out the Incident Tracking Report and email a copy to the Safety
Officer.
● The Safety Officer will inform the President and the VP of Baseball or VP of Softball of the incident.
● The President will inform the Baseball or Softball Player Agents of all injuries.
● The Safety Officer will fill out the Little League Baseball and Softball Accident Notification Form and
submit the claim to Little League International
● A claim must be submitted within 20 days of the incident.
● The parents/guardians of the injured player are responsible for paying all bills to the medical facility
where treatment occurred. Parents will need to supply Little League International with copies of any
and all bills and LLI will reimburse the parents/guardians directly. LLI will NOT pay any bills directly
to the medical facility.
● If the injury isn't reported within 20 days of the incident GLL will not pay any medical bills as a result.
Managers and Coaches are responsible for knowing the procedure and instructing the
parents/guardians.
GLL Contact Information
Safety Officer Bill Lenzo |Contact | 616.206.0130
President Tom VanderVelde | Contact | 616.890.5998
VP Baseball Tim Wright | Contact | 616.304.3010
VP Softball Matt Warsen | Contact | 616.229.5995
Player Agent Matt Alkema | Contact | 616.916.0243