Tournament Grievance Form

TOURNAMENT GRIEVANCE FORM
USTA SOUTHERN CALIFORNIA

PLEASE REVIEW BEFORE SUBMISSION.

This form is to be used for grievances against Southern California players occurring at USTA Southern California-sanctioned junior or adult tournaments.

Any written complaint must be filed within 15 days following the date on which the alleged violation occurred, except in situations where the alleged violation is based on a falsification of age or a falsification of information. Such written complaint must be filed within 15 days after discovery of such falsification.

This form requires information that you may not know on your own and that you will need to collect before being able to complete the form. Allow sufficient time to be able to gather the required information to submit the completed form before the 15-day deadline.

GRIEVANT INFORMATION

TODAY'S DATE(Required)

YOUR NAME (GRIEVANT)(Required)

RELATIONSHIP TO AGGRIEVED PARTY(Required)

YOUR EMAIL ADDRESS(Required)

YOUR CELL/HOME PHONE NUMBER(Required)

ADDRESS(Required)

Street Address (Required) Address Line 2 City State ZIP Code

IF GRIEVANT FILING THE GRIEVANCE IS A MINOR (18 OR UNDER), PROVIDE THE FOLLOWING

PARENT NAME

PARENT EMAIL ADDRESS

PARENT PHONE NUMBER

DID PARENT WITNESS THE ALLEGED VIOLATION?

GRIEVANCE INFORMATION

THEIR NAME (RESPONDENT)(Required)

DATE/TIME OF VIOLATION THAT OCCURRED(Required)

TIME(Required)

TYPE OF EVENT(Required)

TOURNAMENT NAME(Required)

AGE GROUP / DIVISION(Required)

PLAYER NAMES(Required)

TENNIS FACILITY, ADDRESS, AND COURT NUMBER WHERE THE MATCH WAS BEING PLAYED(Required)

NAME OF TOURNAMENT DIRECTOR(Required)

FIRST AND LAST NAME OF TOURNAMENT OFFICIALS INVOLVED(Required)

PLEASE NOTE: It is your responsibility to check on-site at the tournament with the tournament director for the names of tournament officials to complete this information.

STATEMENT OF THE GRIEVANCE

GRIEVANCE(Required)

Describe only the specific incident(s) that you allege as a violation of the USTA or SCTA code of conduct regulation in 2500 characters or less. If there is more than one specific incident that you allege as a violation, then separate each incident out with facts, numbering each incident.

WITNESS(Required)

Provide the full name and contact information (email address and/or telephone number) of any eyewitness who personally observed the incident and has agreed to verify the facts to support the violation. It is your responsibility to confirm with any witness that they are willing to provide their information in the event they need to be contacted.

DATE WITNESS INFORMED YOU THEY ARE WILLING TO VERIFY THE INFORMATION(Required)

PROTEST INFORMATION

NAME OF PERSON(S) WHO MADE PROTEST TO TOURNAMENT OFFICIAL(S)(Required)

DID A TOURNAMENT OFFICIAL PERSONALLY OBSERVE THE VIOLATION?(Required)

If there is more than one violation and more than one tournament official, please explain below.

PROVIDE THE NAME OF THE OFFICIAL AND THE VIOLATION THEY PERSONALLY OBSERVED AS IT HAPPENED

WERE THERE ADDITIONAL VIOLATIONS WITH ADDITIONAL OFFICIALS?

ACTION TAKEN BY THE TOURNAMENT OFFICIAL(Required)

When the tournament official was notified of this complaint regarding the violation, what action did they take? Explain the response of the tournament official, including any words said or action taken by the tournament official to the person whose conduct is the subject of the grievance.

DID THE OFFICIAL GIVE ANY WARNINGS?(Required)

IF SO, IDENTIFY THE TOURNAMENT OFFICIAL, THE SPECIFIC WARNINGS (QUOTE THE WORDS ACCURATELY), AND WHEN THEY WERE GIVEN

DID A TOURNAMENT OFFICIAL OVERRULE ANY CALLS?(Required)

IF SO, IDENTIFY THE TOURNAMENT OFFICIAL, THE OVERRULED CALLS, PENALTIES IMPOSED, AND WHEN IT OCCURED

CONFIRMATION OF ACCURACY

I CONFIRM THIS FROM WAS FILLED OUT ACCURATELY(Required)

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.(Required)

E-SIGN (TYPE YOUR NAME)(Required)

PLEASE COMPLETE SECURITY CHECK