Wasteland World Incident Form
IF YOU ARE CURRENTLY AT ONE OF OUR EVENTS, DO NOT USE THIS FORM - REPORT IN-PERSON AS SOON AS POSSIBLE TO OUR MEDICAL OR SECURITY STAFF ON-SITE. This form is for reporting incidents directly to WW. Incidents that occurred at our in-person events are our top priority, but we may also followup on incidents that have occurred outside of our events if there is a clear threat to our on-site attendees.
Date of incident(s) dd/mm/yyyy
(if known)
Time of Incident (or time of first incident if multiple) (If known)
1
2
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4
5
6
7
8
9
10
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:
Hour
00
10
20
30
40
50
Minutes
AM
PM
AM/PM Option
Location of Incident
*
If at WW, what camp, block, or street did this occur? Could also be at another official WW event, on social media, via private message, or just "online"
Who is reporting the incident:
Your Name:
*
By: First Name
By: Last Name
Your Tribe Name
*
What tribe do you belong to? If none, write "none".
Your Email
*
example@example.com
Your Phone (optional)
-
Area Code
Phone Number
Are you:
*
The victim of the incident(s)
A direct witness to the incident(s) but not the victim
Name(s) and contact information (if known) of person who inflicted harm
Regarding Attendee:
Re: First Name
Re: Last Name
Attendee Tribe Name or Camp Location
Where do they camp?
What happened?
*
Include as much detail as possible, including names of who was involved or present.
What was the end result?
How was the situation left? Where do things stand currently? Was this already reported (to staff, medical dept, law enforcement, or a tribemate or tribe leader?)
Do you believe this person is a threat to the physical safety of one or more attendees at our in-person events? If so, please explain.
What is the ideal outcome for you as a result of making this report? (optional). (Please be aware that your desired outcome may not be be the final result of this process).
People report incidents for different reasons. Do you just want us to know in case there are other complaints? Do you just want event security to try and keep an eye on this person? Do you want the person banned from attending all Wasteland World events? Banned from our official online groups? Would you simply like an apology? Do you want the person banned from entering your camp or communicating with you in any way at in-person events? Something else?
You may include photos or screenshots of abusive or harassing communication if it would be pertinent
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OTHER RESOURCES
RAINN / National Sexual Assault Hotline: 1-800-656-4673 (24 hours). National Domestic Violence Hotline: 1-800-799-SAFE (7233). NAMI (National Alliance on Mental Illness) Helpline: 1-800-950-NAMI (6264) (M-F 7am-5pm PT) or info@nami.org
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