Please copy paste this reporting form and submit to the current officers of the Delaware River Rowing Club. There is a collection box in the boathouse located at The Jack McBride Boathouse, 3 York St, Burlington, NJ 08016 See also this web page's "Contact Us" section for further information on how to report your concerns.
DELAWARE RIVER ROWING CLUB strongly encourages the reporting of misconduct.
DRRC appreciates your willingness to report inappropriate behavior. Please use the back of this page if you need additional space.
This section is about the individual you are reporting. Please provide as much information as possible.
1. Name of Individual you are reporting (First & Last):
2. Age or Approximate Age
3. Gender
Male Female
4. Address (City, State required)
5. Position(s) this individual holds or held:
6. Club where individual works and/or volunteers or worked/volunteered previously:
This section asks questions about the incident or incidents you are reporting. Please provide as much specific information as you are able.
7. Type of Offense (i.e. what happened?)
8. Where did the incident or incidents take place? (City, State and any other available location information)
9. Please Describe what happened: (Including... Who, How, What, When, Where)
This section is for information about the victim or victims. If you are the victim and wish to remain anonymous, you may do so. In that case, please enter only your age, city, state, and Club affiliation.
10. Name:
11. Age (or approximate age)
12. Club affiliation (if any):
13. Contact phone number (Note, if this person is under 18, please provide contact information for his/her parent or guardian):
14. Contact Email address (if this individual is under 18, please provide contact information for parent or guardian):
15. Gender Male Female
Your Information: You may remain anonymous if you wish. However, providing your information is vastly helpful to a swift and effective investigation. A person reporting alleged misconduct should not fear any retribution and/or consequence when filing a report he or she believes to be true.
16. Name:
17. Phone Number:
18. Email Address
19. Club Affiliation (if any):
20. Relationship to victim (if any):
Other Information
21. If you have any other information that you feel would be helpful to an investigation of the alleged offense you have reported, please enter it here:
The Delaware River Rowing Club does not investigate suspicions or allegations of child physical or sexual abuse, or attempt to evaluate the credibility or validity of such allegations, as a condition of reporting suspicions or allegations to the appropriate law enforcement authorities.