Incident Report Form

This form is to be utilized by anyone in SMBA’S programs to report an incident of unacceptable behavior.  An individual is considered to be displaying unacceptable behavior if they are verbally or physically harassing and/or abusing a game participant (player, coach, spectator, or official).

Relevant Information regarding the following incident: Please include only FACTUAL INFORMATION rather than opinions of what might have happened or opinions of what should have been done. Please keep in mind that in the interest of transparency of process, information contained in these reports may be shared with those named or involved, although the name(s) of the people providing the information will only be known by the discipline committee.

You can expect an official to investigate your report.  Unfortunately, a written response to all reports is not always possible, but we do however hope to be able to contact you at some point during or after the investigation.  Resolution typically takes 2 to 4 weeks from receipt.

Email *
Please provide your contact information as per the questions below, in case a follow up by the SMBA Discipline Committee is needed to acquire further information or clarification.
Name of person providing the following information *
Email: *
Phone Number *

Date of the report (YYYY/MM/DD)

 *
MM
/
DD
/
YYYY
Relationship of person providing information *
Type of Incident *
Please see the below URL to our Rules & Bylaws (Code of Conduct) that can be used as guidance on deciding which specific aspects of the SMBA Code of Conduct that you believe has been violated.

Please be advised: if you selected the Violation of SMBA Code of Conduct option above without providing a specific explanation in the following question of how the individual at fault has broken our Code of Conduct, your survey response will not be looked into further.
SMBA (Code of Conduct)
Please provide the specific violation of our Code of Conduct that has been encountered along with an explanation of what happened 
Date of Incident (YYYY/MM/DD) *
MM
/
DD
/
YYYY
Time of Incident *
Time
:
Division of play *
Level of Division (if applicable) *
Gender *
Teams involved *
Location of Incident *

Relevant Information regarding the incident: Please include only FACTUAL INFORMATION rather than opinions of what might have happened or opinions of what should have been done. Please keep in mind that in the interest of transparency of process, information contained in these reports may be shared with those named or involved, although the name(s) of the people providing the information will only be known by the discipline committee.

You can expect an official to investigate your report.  Unfortunately, a written response to all reports is not possible, as our volunteers do not have the resources to do so.  We do however hope to be able to contact complainants at some point during or after the investigation.  Resolution typically takes 2 to 4 weeks from receipt.

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