If other briefly indicate team function / event
Click on the calendar icon to select a date or enter mm/dd/yyyy ie 09/25/2018 then click on the clock icon to edit the time
Please include City ..... Facility ...... Location Within Facility
ONE PARTICIPANT MUST BE ENTERED .... NAME ONLY IS ACCEPTABLE .... CONTACT INFORMATION CAN BE CAPTURED AS NEEDED .... ADD ADDITIONAL PARTICIPANTS IF REQUIRED
Please enter name and role .... i.e. Spectator - Coach - Parent etx
PLEASE INCLUDE AS MANY DETAILS AS POSSIBLE IN THE INCIDENT DESCRIPTION
Allowed extensions: .jpeg, .jpg, .png, gif, .pdf, .doc, .docx, .xls, .xlsx.Maximum # Files: 1. Maximum File Size: 4MB.
Please attach any documents that are relevant to the Incident
PLEASE INCLUDE THE NAMES AND CONTACT INFORMATION OF ANYONE WHO WITNESSED THE INCIDENT AND YOU HAVE CONFIRMED THAT THEY ARE WILLING TO SPEAK TO WHAT THEY WITNESSED
Example: [email protected]. Your submission will be sent to this address.
Please include a brief description as to why the convener was not notified.
Please include a brief description as to why the police were not notified or simply insert N/A
THE OWNER OF THE EMAIL ADDRESS SUBMITTED BELOW WILL BE CONSIDERED THE SIGNATURE OF THE PERSON MAKING THIS SUBMISSION AND THAT THE FACTS ENTERED ARE ACCURATE AND TRUE TO THE BEST OF THEIR RECOLLECTION AT THE TIME OF SUBMISSION .... A COPY OF THIS SUBMISSION WILL BE SENT TO THIS EMAIL ADDRESS