VMHA Conflict Submission Form

Important Notice

Vancouver Minor Hockey Association (VMHA) cannot guarantee complete confidentiality. The contents of this document may be shared in an effort to resolve the complaint herein. By completing this form, you agree that VMHA may share some or all of this information in the process of resolving the complaint, in compliance with the VMHA Privacy Policy.

Complaints will be addressed according to severity, resources, and participant safety.

All concerns/complaints must accompany this VMHA Conflict Submission Form prior to review.

Email the completed form to vp1@vmha.com.

Reminder: Maltreatment, Bullying, or Harassment concerns must be submitted directly to the Independent Third Party (ITP) company per Policy 4 – Maltreatment, Bullying and Harassment Policy. All other concerns can be submitted using this form.

Person Making the Complaint

Role(s):

Player Parent Volunteer Official

Name:

Mailing Address:

City:

Postal Code:

Phone Number:

Email:

Person on Whose Behalf the Complaint Is Made (if different)

Name:

Person(s) Who Committed the Infraction

Type of complaint:

Internal VMHA complaint External complaint (opposing team)

Name 1:

Title/Role 1:

Name 2:

Title/Role 2:

Opposing Team Information (If applicable)

Team Name:

Association:

Complaint Regarding:

Player(s) Coach(es) Other Bench Staff Parent(s)/Spectator(s)

Incident Details

When did the last incident occur?

Game Number (if applicable):

Location:

Description of Complaint (please provide details):