Complaint Form

Please note the following:

Substantiated allegations will be considered for sanctions ranging in severity.
Complete confidentiality of the complaint process cannot be guaranteed. The contents of this document may be shared in an effort to resolve this complaint. By completing the form, you agree that the EC Complaints Manager may share some or all of this information in the process of resolving the complaint.

1 - Person making the complaint

AthleteParentVolunteerOfficialEmployeeWitness to IncidentOther

First Name

Last Name

Address

City/Town

Province

Postal Code

Phone

2 - Person on whose behalf the complaint is made: (to be completed if different from above)

First Name

Last Name

Birth Date (YYYY-MM-dd)

3 - Name of person(s) against whom you are complaining

First Name

Last Name

4 - When and where did the incident(s) occur? (date)

5 - Please check the ground(s) that best describes your complaint

A. Harassment

Type of behaviour ConductGesturesComments

Based on RaceEthnicityDisabilityColourReligionAgeSexual orientationSexMarital statusFamily statusPardoned conviction

B. Abuse

Type of behaviour PhysicalEmotionalSexualNeglect

C. Bullying

Type of behaviour PhysicalVerbalRelationalReactive

D. Misconduct

6 - Particulars

Provide a summary of the incidents you are complaining about. You may attach any additional documents that you feel will help clarify the basis for your complaint.

Your summary must answer the following questions, but is not limited to these questions.

Who was present at the time that the incidents occurred? This includes participants to the incident(s) as well as witnesses. Provide names and any contact information.
Provide a succinct summary of the incident(s) in your own words.
How do the incident(s) relate to the ground(s) you selected above?
What are the remedies or resolutions that you are seeking?

Additional documents (PDF, XLS, XLSX, DOC, DOCX and JPG formats only). Select one or multiple files. Maximum number of files: 10.

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Complaint Form

Complaint Form

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