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SAFESPORT REPORTING FORM

Initial reports of a complaint or accusation of Misconduct will be to the League – and when applicable, to local law enforcement authorities. No direct fees or other cost is involved in making a report. Contact your local authorities if you have a reasonable suspicion that Misconduct has occurred. All reports of Misconduct involving a minor must be reported to local authorities. Reports of Misconduct not involving a minor may also be reported to local authorities.

SafeSport Reporting Form

To report incidents to USA Clay Target League, use of this Safe Sport Incident Report Form is highly encouraged, but not required. Reports of suspicions or allegations of Misconduct may still be made in person, by phone, or otherwise as circumstances dictate.

Please provide as much information as possible. If you are the victim and wish to remain anonymous, you may do so. If you do not know any of the requested information below, or wish to remain anonymous, please indicate so in the space provided.

Please note: You MUST contact your local authorities if the incident you are reporting involves a minor. Additionally, you may contact your local authorities if the incident you are reporting does not involve a minor.

For more information on the reporting requirements, please see the USA Clay Target League Safe Sport Policy.

Person Being Reported

Name

First Last

Age (or approximate)

Team Affiliation (or none)

Position this individual holds or held

Indicent Being Reported

Location the incident(s) took place (Please be as specific as possible – location, city, state, etc)

Date(s) of incident(s)

Description of incident(s)

Victim Information

Name

First Last

Age (or approximate)

Phone

Team Affiliation (or none)

Your relationship to the victim(s)

Additional Information

Please provide any additional details that may help in any investigation of this incident

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Name

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