Complaint - alleged Prohibited Conduct

Report - alleged Prohibited Conduct

to be managed in accordance with the Complaints, Disputes and Discipline Policy (CDDP)
Introduction

This Report Form is for persons who have not been been directly affected by alleged Prohibited Conduct but who have information regarding such alleged conduct. If you were directly affected by the alleged Prohibited Conduct you may make a Report and remain anonymous. However, generally we would recommend directly affected persons to use the Complaint rather than Report process, using the Complaint Form also found on the AFDA website. Complainants cannot remain anonymous.
This form must be completed by the Reporter to initiate the process.
Please provide the best answers you can at this stage.

Our processes are in line with our integrity policies as shown on the AFDA website, in particular clauses 6.5 and 6.6 of the Complaints Disputes and Discipline Policy. A Report may be made anonymously; however such anonymity may limit the action that can be taken in relation to the allegations.

AFDA may be back in touch with you to confirm receipt of your report if you have provided contact details. We may need to seek further information and clarification before proceeding.

Depending on the nature of the alleged behaviour we may need to refer the matter to another organisation such as Sport Integrity Australia which handles child safeguarding and discrimination matters or law enfforcement/child welfare authorities.

AFDA may also contact the relevant Member Organisation or Affiliate organisation to confirm jurisdiction and other matters relating to the subject of the behaviour, the respondent or the circumstances of the case.

However, Reports received by AFDA or Sport Integrity Australia may be recorded for information purposes only with no further action taken. The process for managing a Report will be at the discretion of the Complaints Manager or Sport Integrity Australia.

If you have queries or are unsure about the behaviour you wish to report please contact the National Integrity and Complaint Manager at integrity@afda.com.au prior to submitting your report.
I was the subject of the alleged Prohibited ConductI am NOT the subject but I am reporting the alleged Prohibited Conduct
No I do not require to remain anonymous. I agree to being further contacted to provide further information.I wish to remain anonymous and I understand that this may limit the ability of AFDA to investigate or confirm or take action on the alleged Prohibited Conduct.
Reporter Details

refer to CDDP clause 6.5 and 6.6
Name of Reporter - unless you wish to remain anonymous

First NameLast Name
A Reporter is any person or organisation who or which has reason to believe that Prohibited Conduct may have occurred and makes a Report. A Reporter may be anonymous.

A Report is a submission of allegations that a Respondent has engaged in conduct which may be Prohibited Conduct which does not meet the definition of a Complaint in that the Reporter is not the subject of the alleged conduct or who wishes to remain anonymous.

A Reporter is not entitled to the same rights throughout the Complaints Process as a Complainant. For example, a Reporter may not be kept informed of any decisions made in relation to the Report or participate in any Alternative Dispute Resolution.
Over 18 yearsUnder 18 years
ACTNew South WalesNorthern TerritoryQueenslandSouth AustraliaTasmaniaVictoriaWestern Australia
Reporter's Phone Number - Optional for anonymous reports
Please enter a valid phone number. Format: (000) 000-0000.
Athlete/playerCoach/Assistant CoachSupport Personnel (including physiotherapist, doctor, first aider, chaperone)Official/Game AdvisorVolunteer, including event staffBoard/Committee memberEmployee (paid)ParentSpectatorOther
Reporter's Email Address - Optional for anonymous reports
example@example.com
If you are associated with a club or team, please advise which club/ team you are associated with - Optional for anonymous reports
Details about the person who was the subject of the alleged Prohibited Conduct (the "Subject")

If you were the person who was subject of the alleged Prohibited Conduct some of these questions will be repeated from above - please respond anyway
Name of the person subjected to the alleged Prohibited Conduct (if different from the Reporter)

First NameLast Name
What is your relationship to the subject of the alleged Prohibited Conduct?
Over 18 yearsUnder 18 years
UltimateDisc Golf
Athlete/playerCoach/Assistant CoachSupport Personnel (including physiotherapist, doctor, first aider, chaperone)Official/Game AdvisorVolunteer, including event staffBoard/Committee memberEmployee (paid)ParentSpectatorOther
ACTNew South WalesNorthern TerritoryQueenslandSouth AustraliaTasmaniaVictoriaWestern Australia
Subject or Parent/Carer's Email Address - if known
example@example.com
Subject or Parent/Carer's Phone Number - if known
Please enter a valid phone number. Format: (000) 000-0000.
Respondent Details

The Respondent is the person who is alleged to have engaged in Prohibited Conduct
What is the name of the Respondent?*

First NameLast Name
Over 18 yearsUnder 18 yearsNot known
Athlete/playerCoach/Assistant CoachSupport Personnel (including physiotherapist, doctor, first aider, chaperone)Official/Game AdvisorVolunteer, including event staffBoard/Committee memberEmployee (paid)ParentSpectatorOther
ACTNew South WalesNorthern TerritoryQueenslandSouth AustraliaTasmaniaVictoriaWestern AustraliaNot known
Which organisation (team, club, State, other) is the Respondent associated with?
Details of the Alleged Prohibited Conduct
Child SafeguardingMember ProtectionImproper Use of Drugs or MedicineCompetition Manipulation and Sports GamblingCode of Conduct
What date did the alleged Prohibited Conduct occur?*
What time did the alleged Prohibited Conduct occur?*
Where did the alleged Prohibited Conduct occur?*
National - where the Complaint relates to behaviour, an incident or circumstances that occurred at or involved individuals operating at the AFDA level (including national events, national teams training, tours and matches)State - where the alleged Prohibited Conduct occurred in relation to State administration or State-run event or other activityLocal - where the alleged Prohibited Conduct occurred within a Club or Team or other flying disc organisation
During a matchAt an event venueAway from an event venueOther
If the incident occurred during a match, which match at what venue?
Which field or change rooms or other location
If the incident occurred at an event venue but not in a match, specifically where?
Which field or change rooms or other location
If the incident occurred away from an event venue, specifically where?
The address and whether this was at accommodation or a public venue - please name
Please describe the actions/circumstances of the alleged Prohibited Conduct*
include specific details including language, actions, outcomes and the name)s) of any persons who were the subject of the alleged breach (if applicable)
Please advise the names and contact details of any witnesses who may have observed the alleged Prohibited Conduct*
If there were no witnesses please state this
If you need to attach any further documentation please do so here.

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I have read the relevant NIF policy or the Code of Conduct and the Complaints, Disputes and Discipline Policy.
the information I have provided is to the best of my knowledge true and correct
Signature of Reporter*
Should be Empty:

Report - alleged Prohibited Conduct

Introduction

Reporter Details

Details about the person who was the subject of the alleged Prohibited Conduct (the "Subject")

Respondent Details

Details of the Alleged Prohibited Conduct