Player Grievance Form

USTA SOCAL Tennis

The Grievance Form is intended for grievances on Southern California players that occurred at a Southern California sanctioned tournament (non-National tournament).

Please note any written complaint must be filed within 15 days following the date on which the alleged violation occured, except that if the alleged violation is based on a falsification of age, or a falsification of any information, such written complaint must be filed within 15 days after discovery of such falsification.

Today's Date*
MM slash DD slash YYYY
Your Name, Grievant*
Your Email*
Your Cell/Home Number*
Your Work Number*
Your Address*
Street Address Address Line 2 City State ZIP Code
Grievance Information
Their Name*
Date Violation Occurred*
MM slash DD slash YYYY
Violation Code

Please reference the code of conduct violated, if known.
Tournament Name / Division / Age Group
Names of Tournament Officials Involved
USTA or SCTA Regulation or Policy Violated
Select Type of Event
Statement of the Grievance
Describe only the specific incident(s) that you allege as a violation of the USTA or SCTA code of conduct regulation in 500 words or less. If there is more than one specific incident that you allege as a violation, then separate each incident out as with facts, numbering each incident*
Provide the full name and contact information (email address) of any witness to the incident who has agreed to verify the facts supporting the violation.
State what protest you made to others relating to this incident.
*
- Confirm – By checking this box I confirm I am stating only what I know to be factually true. Stating the whole truth, including what others did and what I did myself.
E-Sign (Type your Name)

USTA SOCAL Tennis

Player Grievance Form

Grievance Information

Statement of the Grievance