USPK Incident Report Form

USPK Incident Report Form

Thank you for taking the time and energy to share your concern with United States Parkour Association (USPK). Our organization is committed to creating safe and inclusive environments across our various platforms whether that be an event, community initiative, etc.
To report a concern, complaint, or misconduct, please complete this form to the best of your ability. All submissions will be reviewed and handled in accordance with United States Parkour Association's policies and procedures.
A report is anonymous by default and may be filled out without self-identification. You may opt-in to being identified if you wish to share contact information.

Contact Information
Our report is anonymous by default and you will remain anonymous by skipping this section.

You may opt-in to being identified by providing your contact information in this section. By opting in, you consent to:
- being identified internally to our Ethics Committee; &
- being contacted if a follow-up is needed for additional details.
Preferred Name (To remain anonymous, you may skip this section.)

First NameLast Name
Email (To remain anonymous, you may skip this section.)
example@example.com
Phone Number (To remain anonymous, you may skip this section.)
Please enter a valid phone number.Format: (000) 000-0000.

Incident / Complaint Details
Date of Incident

MonthDayYear
Date
Time of Incident (if applicable)

Hour Minutes

AM/PM Option
Location of Incident
If possible, the name of the event, program, etc.
If known, the names of individuals involved
If known, the relationship of individual(s) involved in the incident to United States Parkour Association (e.g. athlete, coach, volunteer, etc.)
Please describe the incident or concern in as much detail as possible. Include what happened, who was involved, and any witnesses.

Supporting Evidence
Were there any witnesses? If so, please provide names and contact information if known.
Please upload any evidence that can be shared (photos, video, documents, links, etc.).

Cancelof

Impact & Desired Outcome
Has the incident been reported elsewhere?
With a gym, coach, emergency services, local police, SafeSport, etc?
How has this incident impacted you or others?
What resolution or action do you feel would be appropriate?

Contact Information