Member Complaint Form

Complaints are governed by USA Rugby's Grievance Policy. Complaints will be handled in accordance with USA Rugby's Complaint Resolution Policy. Please use this form to submit your Complaint to USA Rugby.

*USA Rugby may charge a fee for an Administrative Grievance.

For a SafeSport or USA Rugby SafeSport Program matter, please report any instances of sexual abuse or misconduct to the U.S. Center for SafeSport here. Please report physical abuse, emotional abuse, for violations of the USA Rugby MAAPP here. You may report anonymously.

Name

First NameLast Name

USA Rugby Member ID

Your USA Rugby Member ID can be found in your Rugby Xplorer Account. If you do not know your Member ID Number, or do not have one, then please write in N/A.

Phone Number

Area CodePhone Number

Email

example@example.com

Date of Complaint

Date

Which category best describes your complaint?

Other

If you chose "Other," please list the Policy that you believe gives USA Rugby authority to address your complaint in the text box below.

Please provide a summary of the incident or matter, the parties involved, where and when the incident happened and how it affected you.

Name of Respondents

Please identify the rule, policy, code, or law relevant to this matter

What outcome or solution are you seeking?

If you selected 'Opportunity to Participate' or 'Administrative Grievance' above, do you request a hearing?

Other

Please state anything else you would like USA Rugby to know about this complaint.

You may upload support files here

Browse Files

Member Report Form