EmailMe Form - SC Flame - Witness Statement

Name *

First Last

Email *

I was: *

Opposition Team: *

League: *

Grade: *

Venue: *

Date 0f kick Off: *

DD / MM / YYYY

Time of Kick Off: *

HH : MM AM/PM

Incident Report: *

Key Points for your incident report:
- A short, clear and concise report is required. What you saw, what you heard or what someone reported to you.
- It's important to remember where you were in relation to the incident (the actual location/distance from incident)
- Indicate distinguishing details of the Participants of the incident (e.g. blue baseball cap /sunglasses/xx FC t-shirt)
- You can either use dot points or paragraphs.
- Only facts, no opinions.

Please upload any attachments to this statement below.

Signature *

Clear

By submitting this witness/incident report you understand that SC Flame will make further investigations into the details you have provided.

Date of Submission *

DD / MM / YYYY