PCSS SafeSport Violation Report
This violation report is anonymous.
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Please provide information on the person you are reporting. If you do not know the person's name, please provide other identifying information. *
Age or approximate age of the person you are reporting: *
Gender of the person you are reporting: *
Which position does this individual hold? *
Required
What type of offense? *
 i.e. bullying, hazing, physical abuse, verbal abuse, drug use/possession; if you are reporting sexual abuse, please contact SafeSport.org directly at (866) 200-0796
Where did the incident take place? *
i.e. locker room, chair lift, dry land training, hotel, etc.
What happened in detail? *
Who? What? When?
Who was the victim? *
Estimated age / name if known
What is your relationship to the victim? *
You may remain anonymous if you wish. However, providing your information is helpful to an effective follow up. A person reporting alleged misconduct should not fear any retribution and/or consequence when filing a report he or she believes to be true.
Do you  want us to follow up with you directly about this incident?  If yes, please provide a way for us to contact you below.  If you do not answer this question, the report will be anonymous.
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