Injury Reporting

Thank you for reporting your injury!

All registered NSA players, coaches, and officials are covered under the BC Soccer Sport Accident Insurance Program. for sanctioned activities.

Now please fill out the attached Participant Accident Claims form.

Injury Report
Name of person submitting the report
Name of person submitting the report
First Name
Last Name
Time of incident
Name of injured person
Name of injured person
First Name
Last Name
Address of injured person
Address of injured person
City
State/Province
Zip/Postal
Country
Name of guardian or parent (if injured is a minor)
Name of guardian or parent (if injured is a minor)
First Name
Last Name
Name of witness
Name of witness
First Name
Last Name
Name of witness
Name of witness
First Name
Last Name
Name of person giving the treatment:
Name of person giving the treatment:
First Name
Last Name

The Nelson Soccer Association (NSA) is a non-profit community soccer association whose mission is to provide all soccer players, coaches, officials and parents in Nelson and the surrounding area with programs and opportunities to learn, play and excel in the sport of soccer.

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