USA Pentathlon Reporting Form
USA Pentathlon strongly encourages the reporting of misconduct and appreciates your willingness to report inappropriate behavior. USA Pentathlon will maintain confidentiality to the extent possible by law. Please provide as much specific information as possible, with the understanding that you may not have information in response to every question.Please provide as much information about yourself as you are willing. While you can leave sections blank or report anonymously, this could prevent us from getting information we need. If you have any questions, please email athletesafety@usapentathlon.org
Name
First Name
Last Name
Email
example@example.com
Phone Number
Please enter a valid phone number.
Reporters Gym or Team affiliation, (if any.)
Please provide as much information about the person you are reporting. We refer to the person that has allegedly committed misconduct as a respondent.
Full Name of the respondent
First Name
Last Name
City and State of respondent
Phone Number of respondent
Please enter a valid phone number.
Email address of the respondent
example@example.com
Age of respondent
Position or role of the respondent (for example: coach, gym employee, athlete, etc.)
Gym/team affiliation of the respondent
Please provide as much information about the person that was allegedly a victim of misconduct. We refer to the person that was allegedly a victim of misconduct as a claimant.
Full name of the claimant
First Name
Last Name
City/State of claimant
Phone Number of claimant
Please enter a valid phone number.
Email address of claimant
example@example.com
Age of claimant
Gym/team affiliation of the claimant
In this section you will provide details of the alleged misconduct. Please provide as much detail as possible.
Please describe what happened; this should be as detailed as possible
When did the incident occur? (while this should be as detailed as possible, approximate dates are okay as long as it is noted)
Where did the incident occur?
Please list additional witness names and contact information
Please use this space to provide any additional information regarding this incident
Submit
Should be Empty: