Safe Sport Reporting Form

USA Swimming requires reporting of sexual misconduct by any member and strongly encourages reporting of any concerns relating to safe sport. USA Swimming appreciates your willingness to report inappropriate behavior. By submitting this form, you are giving permission to USA Swimming's Safe Sport Program staff to contact you.

Out of respect for the importance of this issue and to encourage honest and effective reporting, knowingly making a false or vindictive report will not be tolerated and may be a violation of USA Swimming's Code of Conduct.
Person Being Reported
Provide as much information as possible about the person you are reporting.
First name *
Last name *
Approximate Age*
Gender*

malefemale
Club Affiliation (or None) :*
Position this person holds*

Head CoachAssistant CoachAthleteOfficialOther
Alleged Offense Information
Provide as much specific information as you are able.
Type of Offense (select all that apply) *

Physical AbuseSexual AbuseInappropriate CommunicationInappropriate TouchingTravel Policy ViolationInappropriate PhotographyOther
Location that the incident(s) took place. Enter Unknown or city, state, specific location, etc *
Dates(s) of Alleged Offense:
Description of Alleged Offense (include as much detail as possible) *
Knowledge of any victim(s) involved in the alleged offense

I am not aware of any victimsI am aware of victims
First Name (or Anonymous or Unknown) :
Last Name (or Anonymous or Unknown) :
Age or Approximate Age
Club Affiliation (or None)
Additional Information
You may make a report anonymously or provide your icontact information. Thank you for taking the time.
Name

First NameLast Name
USA Swimming Member

YesNoUnsure
Club Affiliation (or None)
Relationship to victim
Enter any other information that you feel would be helpful to an investigation of the alleged offense you have reported:
Should be Empty: