NOTE: Cumberland Kayak does not accept paper waivers, please submit electronically.

Vehicle Incident Report

This form is used for internal reporting of damage to company vehicles or other automotive accidents

Name of Driver

Who was driving the vehicle at the time of incident?

Incident Date

Which vehicle did this incident affect?

Incident Description

Please provide a description of what happened. How and why did the incident take place?

Damage to Company Vehicle

What damage was done to company property? Please provide specifics such as size, location, and severity.

Did this incident involve damage to another vehicle or property?

Yes

If yes, please provide a description of damage done to the other vehicle/property.

Thank you for providing this information related to an incident with a Cumberland Kayak & Adventure Company vehicle. If applicable, please take photos of damage and send to jordan@cumberlandkayakadventure.com and dylan@cumberlandkayakadventure.com.

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Driver Signature

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