LSA Incident Report
Please provide a detailed and factual description of the incident, including all relevant information and circumstances.
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Email *
Type of Incident ( you can select more than one) *
Required
Date of Incident *
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DD
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YYYY
Time
:
Type of Event *
Location/Venue of Incident *
Team Gender *
Team Age Group *
Team Division *
Coaches Name of Involved Team *
Individuals Involved *
Required
Details of Incident *
Please provide a clear and detailed description of the incident, ensuring accuracy in your account. The information you submit will be evaluated by the Leduc Soccer Association's board members and Technical Director, except if they are directly involved in the incident. Note that only incidents reported through this process will be addressed with.  Please email any documents or photos to incident@leducsoccer.ca
I hereby affirm that the information provided in this incident form is accurate and truthful to the best of my knowledge. I understand that providing false or misleading information can have serious consequences and may affect the resolution of the incident. I agree to cooperate fully in any further inquiries or investigations related to this incident. *
Required
Name of Person Submitting this Incident Report *
Phone Number of Person Submitting this Incident Report. *
Date and Time of Submission *
MM
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DD
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YYYY
Time
:
A copy of your responses will be emailed to the address you provided.
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