Alpine Mountaineer Pop Warner Football

Incident/Complaint Report Form

By signing this form-I understand that in order for the Incident or Complaint to be handled properly and to insure that everyone in the Alpine Mountaineer Football & Cheer is working together for positive solutions. I must complete the following and follow the chain of command. Not following the chain of command could result in disciplinary action by the Conference Executive Board of Directors.

Instructions: Form must be completed in full and a signature is required. If there are witnesses to the Incident please list their names. Forward the Form to the President of your Association and CC: Copy to Commissioner, Vice Commissioner or Cheer Commissioner.

Date:___________ Date Incident Took Place_____________ Association Location of Incident_________________

Team Division______________________(cheer) (football)

Name of the Accused__________________________________________________

Position in the Association______________________________________________

Example: (parent, participant, coach, official, board member, other volunteer position)

Facts: (all relevant facts including exact quotes as appropriate to describe)

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Suggestions on Resolving the Incident or Problem: (suggestions does not mean this is the action that will be taken)

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Investigated by:______________________________

Spoke with the Accused on: Date________________

Spoke to Witness on: Date______________________

Results of Conversation:

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Association Board Recommendations in Resolving. Investigated by:_________________

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Action Taken by the Association Board: (must be in the minutes of meetings) Conclusion:

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Signature of Complaint__________________________________ Phone_____________

Signature of Witness____________________________________ Phone_____________

Signature of Association President_________________________ Date______________

Vice Commissioner or Cheer Commissioner Signature____________________________

Commissioner Signature________________________________