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Anonymous Safety Report
This form is for dancers at FusioNation events to anonymously report safety incidents.
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* Indicates required question
When did this incident occur?
*
MM
/
DD
/
YYYY
When did the incident happen?
*
Before the dance event
During the dance event
After the dance event
What happened? Is this a recurring problem?
*
Your answer
Would you like to leave your email so we can follow up with you?
*
Yes, please contact me. I will fill out my contact info on the next page.
No, I wish to remain anonymous and want to submit this form as-is.
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