Dispute Resolution Form (Tecumseh Minor Ball Association)

Dispute Resolution Form

Please fill out all areas to the best of your ability. The more information supplied will assist with investigating, and responding to your concern. All forms will be addressed within 72 business hours.

Section 1: General Information

Date of Submission:^*

Required

(Today's Date)

Name of Person Submitting Form:^*

Required

Role in Organization:^*

Required

Phone Number:

Email Address:

Example: [email protected]

Team Associated with Incident

(ex. House League 13U or REP 14U)

Section 2: Nature of Complaint or Incident

Please select the type of issue being reported:^*

Required

Date of Incident(s):^*

Required

Location & Time of Incident(s):^*

Required

Individual(s) Involved:^*

Required

Witnesses

(If Applicable)

Section 3: Description of Incident

Please provide a detailed description of the incident(s). Include specific actions, words used, impact, and any attempts to resolve the matter prior to submitting this form.^*

Required

Section 4: Desired Outcome

If you answered "Other", please indicate the desired outcome you are looking for;

All information submitted will be handled with discretion and in accordance with the league’s privacy and disciplinary policies. Retaliation for submitting a complaint is strictly prohibited.

What outcome or action would you like to see as a result of this report?^*

Mediation between parties
Formal Investigation
Disciplinary action (ex., Suspension, Warning)
No Further Action - For Documentation Only

Required

Dispute Resolution Form (Tecumseh Minor Ball Association)

Section 1: General Information

Section 2: Nature of Complaint or Incident

Section 3: Description of Incident

Section 4: Desired Outcome

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