Mavericks Hockey Association Complaint Form

Mavericks Hockey Association Complaint Form
Complainant Information
Complainants Role *

Player Coach/Assistant Coach Manager Game Official Parent/Guardian Volunteer Mavericks Hockey Board Member Game Spectator
Name *

First Name Last Name
Phone Number *

Area Code Phone Number
E-mail *
If Complainant is a Minor please select and complete the next 4 sections

Complainant is a Minor
Name

First Name Last Name
Relationship to Complainant
Phone Number

Area Code Phone Number
E-mail
Information Regarding Complaint
Primary Person Involved in Complaint *

First Name Last Name
Team *

Age Group Division
Nature of Complaint *
Date of Incident *

Year Month Day
at
Hour Minutes AM/PM Option Date Picker Icon
Location *
Summary of Incident *
Names of Witnesses (provide contact information for Witnesses if possible)
I hereby certify that to the best of my knowledge and belief that the above-mentioned information is true, accurate and complete. I am aware that making false, malicious or frivolous allegations is in violation of the Respectful Hockey Policy and subject to disciplinary action by Mavericks Hockey Association. I further recognize that the contents of this document and any attachments (with the exception of any witness list provided) will be shared with the person(s) against whom it has been filed.
Should be Empty: