Rendezvous Incident Report

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Use this form to report incidents, including consent violations, inappropriate behavior, micro or macro aggressions, or harassment of any kind. Reporting builds awareness, strengthens our community, and creates a written record of concern. All of your answers will be held strictly confidential to the organizers and Care Team unless you give explicit consent otherwise. All reports are available for the General Coordinator, Instructor Coordinator, and Youth Program Coordinator. Other relevant staff members of this or other events may request reports by name of the offender.

Where the incident took place:

At Rendezvous, on site during the gathering or during setup and breakdown

At another Earthskills Gathering or event (such as Firefly, Florida Earthskills, Piedmont, etc)

Other:

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When the incident took place (please provide a date and approximate time).

Who were the people involved? If you don't know their name(s), or if you wish to keep their identity confidential, please state so here. Alternatively, if you would like us to follow up with them, please give their name(s) and any contact information you have for them.

What happened? Please provide a detailed description of the incident you want to bring to our attention. What was said and/or done? What boundaries were crossed? What did you not feel comfortable with?

Did anyone else witness this incident or behavior? Please be specific about individuals.

Have you, or do you intend to, follow up with the person(s) involved on your own?

Yes

Undecided

Other:

Clear selection

Do you feel unsafe around the person(s) involved in incident(s)?

Yes

Sometimes

Unsure

Other:

Clear selection

What sort of response would you like?

I just want to report the incident so you know about it - no further follow up is needed.

I would like to speak to someone on the Care Team about this privately.

I would like for you to look into this on my behalf and follow up with the involved person(s).

I would like your support to have a meeting with the involved person(s).

I would like a specific action taken to support me in feeling safe being at Rendezvous (if so, please say what action in the "other" section below)

Other:

Do you want to remain anonymous?

Yes

Clear selection

Your Name (optional) - please include this information if you want us to contact you.

Your Email and/or Phone Number (optional) - please include this information if you want us to contact you.

Is there anything else you would like to add?

What is the current standing or outcome of this issue? What follow-up was done? Were any commitments made by any parties? If so, are there dates those commitments would be fulfilled by?

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