Croquet Australia Complaint Form In line with Sports Integrity Australia, Croquet Australia has introduced a process for dealing with reports of inappropriate behaviours and disputes in croquet in an effective, appropriate and timely manner. Please complete as much information as you can to assist with the process.Further information regarding the complaints process can be found on the Croquet Australia website croquet-australia.com.au Question Title * Select the appropriate option Inappropriate/Prohibited Behaviour Competition Related Dispute Hazard/Potential Hazard Other (please specify) Question Title * Details of person reporting the incident (Complainant). Anonymous complaints many not be actioned. Name Phone Email Question Title * Is the complainant over the age of 18? Yes No Question Title * Position held by Complainant Club Administrator (Volunteer) Player Parent Official Coach Team Manager Spectator Support Personnel Board/Committee Member Employee (Paid) Other (please specify) Question Title * Name of the person being complainted about (Respondent) Question Title * Position held by Respondent Club Administrator (Volunteer) Player Parent Official Coach Team Manager Spectator Support Personnel Board/Committee Member Employee (Paid) Other (please specify) Question Title * Incident Details Date of Incident Time of Incident Location of Incident Question Title * Description of alleged breach/incident by Respondent.Please provide as much information as possible. Question Title * Enter details for any witnesses Witness 1 Name Email Phone Witness 2 Name Email Phone Witness 3 Name Email Phone Question Title * Level of the Sport at which the alleged breach/incident occured National (Croquet Australia) level where they relate to behaviours, incident or circumstance that occured at or invovle individuals operating at the national level State level where they relate to behaviours, an incident or circumstance that occurred at or involve individuals operating at the State/Territory sporting association level Affiliate level where it relates to behaviours, an incident or circumstance that occurred at or involve individuals operating at the Association/Club level Question Title * Policy that the Respondent has allegedly breached. Member Protection Policy Personal Grievance Policy Other Policy (please specify) Question Title * Sections allegedly breached 1. 2. 3. Question Title * Does the Complainant consent to Alternate Dispute Resolution (mediation)? Yes No Question Title * Acknowledgement I acknowlege that the information above it true and correct Question Title * Date of form completion Done
