Burners.at Online Incident Report Form

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To file a report with the Burners.at Consent-Committee, please fill out and submit this Incident Report Form. The form collects information regarding possible Code of Conduct violations. The completed form should contain sufficient detail for the investigators to begin an investigation, if so wished. All information in this form will be handled confidentially as stated in the Confidentiality Agreement.

For more info on the Committee: What is the Consent Committee? (burners.at)

Your Name

Report anonymously *only* if you do not wish to have any follow up. Anonymous information can be useful when it contains verifiable facts but information with no contact information is, by its nature, of limited value in our process.

Please enter preferred contact details on-site and (can be different) off-site

eg: phone number for a classic phone call, Whatsapp, Signal, Telegram, Email, Messenger etc.

What is the nature of the violation that you wish to report? *

Please check all that apply.

Physical Endangerment and/or Violence

Sexual Misconduct

Intimidating or Threatening Behavior

History of Prior Misconduct

Non-Consensual Intoxication

Predatory Behavior

Misuse of Position or Authority

Trespassing

Disregard, Misuse, and/or Theft of Event Property

Disregard, Misuse, and/or Theft of Participant’s Property

Other:

Required

Name of the person(s) you are reporting (or physical details helping to identify)

Include or indicate any alias. You can also give us any physical detail you would remember if you don't know the name of the person. However it is ok if you don't remember anything, this can be part of the injury you go through, nothing you should blame yourself for.

How is the person connected to the Austrian Burners Community? *

For example has the person attended Schönburn, Burning Cafe or other burn events inside or outside the local community?

Please note the date and time, if possible, when the incident took place.

If you're reporting several instances, please enter a time range and note any specific instances.

Where did the incident or incidents take place? *

Were bystanders present when the incident(s) occurred? *

If yes, please specify if you are acquainted with them, in case the investigators need to reach out to them with your approval. Include email addresses if possible and appropriate. We will not contact anyone without discussing the case with you first.

Basis of Complaint

Please describe the incident(s).

Please state your intention for filing this report.

No investigation, for information purposes only

Please investigate

Procedural questions or concerns about Consent Committee's functioning

I'm not sure and would like to discuss further before deciding

Clear selection

The Consent Committee will not pursue legal action, however if you were to do so on your own, all recorded communication received by the Consent Committee (starting with this report) can be subpoenaed under certain circumstances.

I understand

Anything else you would like to share with us before a first contact (such as your native language or the gender you would feel most comfortable talking to)

The Consent Committee members are:

Lisa Lorenz

Julie Sommereijns

Markus Schalek

Petra Nußdorfer

Dobromil Zitnansky

GDPR Disclaimer

I consent to my data being stored for a period of up to 36 months from the last date my data was entered or modified, and for it to be used only to facilitate the scheduling and safety of volunteers on behalf of Burners.at. I understand that you will delete my data within one month of my giving formal written notice to the registered address of Burners.at, asking you to do so.

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