Accident Report - UT Power Toys - St George UTV, ATV, RZR Rentals

Polaris RZR Accident Incident Report

Please fill out this form completely and accurately to report an incident involving a rented Polaris RZR.

Incident Details

Date of Incident

Time of Incident

Location of Incident (Address or Coordinates)

Weather Conditions at Time of Incident

Polaris RZR Vehicle Information

RZR Model

RZR Year

Vehicle Identification Number (VIN)

Rental Agreement Number

Driver Information

Driver’s Full Name

Driver’s Phone Number

Driver’s Email Address

Driver’s License Number

Issuing State/Country of License

Passenger Information (if any)

Passenger 1 Full Name

Passenger 1 Phone Number

Accident Description

Please describe in detail what happened, including the sequence of events, any contributing factors, and how the incident occurred.

Damages

Describe damage to the Polaris RZR (be as specific as possible).

Describe damage to other property or vehicles involved (if any).

Injuries

Describe any injuries to the driver, passengers, or others involved (be specific and note if medical attention was sought).

Witness Information (if any)

Witness 1 Full Name

Witness 1 Phone Number

Police Report Information

Was police notified?

Photos / Videos

Please collect any relevant photos or videos of the incident, including damage to the RZR, other vehicles/property, and the accident scene.
(Note: Actual file upload functionality requires a server-side implementation which is not included in this static HTML form.)

Click to upload or drag and drop

SVG, PNG, JPG or GIF (MAX. 800x400px)

Declaration and Signature

By submitting this form, I declare that the information provided above is true and accurate to the best of my knowledge.

Reporter’s Full Name (Print)

Date of Report