ONPARA Incident/Complaint Report Form
Please complete this form for complaints, minor infractions, major infractions, incidents (threats, fighting, property damage, verbal abuse, etc.)
Affected Party/Parties
*
Please Select
Athlete
Coach
Official
Parent
Volunteer
Spectator
Other
Type of Report
*
Please Select
Incident
Complaint
Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
Please enter a valid phone number.
Email
*
example@example.com
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GUARDIAN/PARENT (If the party affected is a minor)
Name
First Name
Last Name
Email
example@example.com
Phone Number
Please enter a valid phone number.
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INCIDENT/COMPLAINT INFORMATION
Date of incident
*
-
Month
-
Day
Year
Date
Time of incident
*
Hour Minutes
AM
PM
AM/PM Option
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NAME & ROLE OF PERSON REPORTING THE INCIDENT/COMPLAINT
Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Role
*
Where did the incident occur? (competition, team practice, change room, parking lot, etc)
*
Please describe the incident/complaint in full detail (club complaint, coach complaint, slip/fall, physical/verbal assault, property damage, etc.).
*
Please include names of persons being complained about for ONPARA to begin the discipline and complaints process. If no names are provided, ONPARA cannot move forward.
*
If you are reporting an incident, what action was taken on site (accused removed from competition site, team forfeited, coach ejected from match, coach removed from club, etc.)?
*
Law enforcement notified
*
Yes
No
Name of Agency
Type a label
Name of Officer
Type a label
Property Damage & Estimated Value(if applicable)
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WITNESS INFORMATION
Please complete this section if you have witnesses that are willing to submit a written account of the incident and if they consent to testify at an ONPARA Discipline Hearing. Please upload any written witness accounts to this form.
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NAME OF WITNESS
NAME
ADDRESS
EMAIL
PHONE #
#1
#2
I agree to the following:
*
I verify that the above statements and information submitted are true.
I give consent to pass this information along to the Discipline and Complaints Review panel.
I give consent to participate a Discipline Hearing and in a follow up interview, if required.
Name
*
First Name
Last Name
Date
*
-
Month
-
Day
Year
Date
Signature
*
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SUBMISSION REQUIREMENTS
Any ONPARA Member may report to the ONPARA Head Office any complaint of an infraction by a Member. Such a complaint must be signed and in writing, and must be filed within fourteen (14) days of the alleged incident. Anonymous complaints may be accepted at the sole discretion of ONPARA'S Executive Director or designate, or the Case Manager. A Complainant wishing to file a complaint beyond the fourteen (14) days must provide a written statement giving reasons for an exemption to this limitation. The decision to accept, or not accept, the notice of complaint outside the fourteen (14) day period will be at the sole discretion of ONPARA. This decision may not be appealed. Upon receiving a complaint, ONPARA will assign a Case Manager within seven (7) days to oversee the management and administration of the submitted complaint. The Case Manager will inform the Parties if the incident is to be dealt with as a minor or major infraction and the matter will be dealt with according to the applicable sections of this Discipline and Complaints.
DATE REPORT SUBMITTED
*
-
Month
-
Day
Year
Date
Signature
*
Submit
Submit
Should be Empty: