Codes and Policies

Contact Name*

MyRugby ID

Gender*

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Your Role*

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Email Address*

Phone Number

Please be aware this form will go to the nominated State Union representative.

State*

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Please be aware this form will go to the competition manager of the competition you select. If you do not want this to occur, please select 'Other Competition' and only the State Union representative will receive it.

Competition/School*

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Your Club/School

Please enter the details of the incident.

Date of the Incident*

Time of the Incident*

Details and/or description of the person you are complaining about.*

If During a Match

Home Team

Away Team

Venue

Grade/Age*

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Description of Incident

Please keep the information objective, factual and provide dates of issue in chronological sequence.

Incident description*

Name of all people involved and positions held*

Name of clubs involved*

Name of any witnesses*

Action taken to date (if any)

Methods (if any) of attempted informal resolution

Age of Person Raising the Case*

Over 18Under 18

*I certify that the above information is true and correct.

Please ensure all required fields are completed before clicking 'submit'.

You will receive an email notification if the case has been submitted successfully.

If you do not receive an email, your case has not been successfully completed and you may need to complete the incident form again.

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