MAD RIVER YOUTH SOCCER LEAGUE (MRYSL) Complaint Form

 

MAD RIVER YOUTH SOCCER LEAGUE (MRYSL) Complaint Form

Rev. Date: 1 February 2015 

Mad River Youth Soccer League (MRYSL) and Mad River United (MRU) take reports of coach, referee, player or parent infractions of league or club policies and codes of conduct seriously. Please use this form to report violations of club or league policies or codes of conduct committed by an individual or individuals. Today’s Date: __________________________ Date of Incident(s): __________________________ Name of Person Filing Complaint (Complainant): ________________________________________________ Complainant’s Phone and/or Email Address: _____________________________________________________________________________________________________ Complainant’s role: Official Coach

Player

Spectator

Parent

Other ________________

Name and role (registrar, board member, etc.) of person completing form if other than Complainant: _____________________________________________________________

This complaint is about the conduct of (fill in person’s name): __________________________________________ who is a(n): Official

Player

Spectator

Coach

Parent

Other ________________

 

P.O. Box 103, Arcata, CA 95518 * www.mrysl.net* (707) 822-3333 ARCATA    BIG LAGOON    BLUE LAKE    FIELDBROOK    HOOPA    MANILA    MCKINLEYVILLE  SALYER     SAMOA    TRINIDAD    WILLOW CREEK 

 

MAD RIVER YOUTH SOCCER LEAGUE (MRYSL) Complaint Form

Rev. Date: 1 February 2015 

Please describe the incident or event. Attach another sheet if necessary. Please attach or include any supporting evidence, including witness names and phone numbers. ___________________________________________________________________________________________________________ ___________________________________________________________________________________________________________ ___________________________________________________________________________________________________________ ___________________________________________________________________________________________________________ The incident or event described violates (check one or more boxes below and fill in the rule, policy, or code of conduct name): CalNorth rule, policy, or code of conduct _____________________________________________________________________________________________________ NorCal Premier rule, policy, or code of conduct _____________________________________________________________________________________________________ USYS rule, policy, or code of conduct _____________________________________________________________________________________________________ MRYSL/MRU rule, policy, or code of conduct _____________________________________________________________________________________________________ Other (explain) rule, policy, or code of conduct _____________________________________________________________________________________________________

For official use only below the line Date received: _________________

Received by: ___________________

Sent to (check all that apply): Rec Director of Coaching on _________________ MRU Director of Coaching on _________________ MRU Committee Chair on _________________ PAD Committee Chair on _________________

MRYSL BoD President on _________________ CalNorth District Rep on _________________ NorCal Premier District Rep on _________________ Referee Coordinator on _________________ No action taken. Explain: ________________________________________________________

P.O. Box 103, Arcata, CA 95518 * www.mrysl.net* (707) 822-3333 ARCATA    BIG LAGOON    BLUE LAKE    FIELDBROOK    HOOPA    MANILA    MCKINLEYVILLE  SALYER     SAMOA    TRINIDAD    WILLOW CREEK