Bismarck Hockey Boosters Grievance Form

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This form must be completed in its entirety before submitting. Incomplete forms will be returned to the originator for completion before a review will occur.

Submit this completed form to the Off-Ice Coordinator of the level involved in the incident being reported.

Please refer to the BHB Disciplinary Policy, which can be found on the BHB website, for more information.

Email *

Name of Individual Submitting Report *

Date Incident Occurred *

YYYY

Cell Phone *

Email Address *

List all Potential Witnesses to the Incident *

List all Members Affected by Incident *

List all Teams Affected by Incident *

Has the 24-Hour Period Been Honored Before Reporting Incident? *

Yes

Grievance Details - Include Location, Who Was Involved and Details of the Incident

(Be as Specific as Possible in your description)

What are Your Expectations for Resolution of the Incident? *

Send me a copy of my responses.

Submit

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