Sport Protection Violation Reporting Form

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Sport Protection Violation Reporting Form

This form is for individuals reporting violations of Vermont Adaptive's Sports Protection Policy. This policy can be found in our Sports Protection Handbook, which is publicly available on our website or accessible by clicking HERE.

All questions below are optional unless marked with a red asterisk. However, an anonymous report may limit Vermont Adaptive’s ability to investigate and respond to a report. Consequently, Vermont Adaptive strongly encourages individuals submitting violation reports to provide their name and contact information when reporting.

Name of Individual you are reporting (First & Last):

Gender of the individual you are reporting:

Male

Female

Non-binary

Prefer not to answer

Other:

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Street Address (of Individual you are reporting):

City (of Individual you are reporting): *

State (of Individual you are reporting): *

Position(s) this individual holds or held:

Organization where individual works and/or volunteers or worked/volunteered previously:

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