Conduct Incident Report Form

If you believe that a member or visitor to a Tablero event has breached the Tablero code of conduct, please inform us using the form below so that we can investigate.

Our Conflict Resolution and Disciplinary Procedure is documented here.

To be completed by the individual reporting the incident

Person reporting the incident

Contact phone number

Location incident occurred

Date of incident *

Time of incident *

Hours

Minutes

AM/PMAMPM

Individuals involved in the incident *(Please provide whatever information you can about the individuals involved in the incident. If names are not known, please describe the individuals.)

Description of the incident *(Please provide a factual, chronological account of what happened. Avoid speculation or emotional language.)

Nature of the IncidentVerbal Altercation: Heated debate, raised voices, or use of disrespectful, though not hateful, language.Discriminatory Language/Conduct: Use of slurs, derogatory remarks, or prejudice regarding race, gender, sexual orientation, ability, or other protected characteristics.Harassment/Intimidation: Stalking, unwelcome attention, or persistent behavior that makes others feel unsafe.Physical Conduct: Unwanted physical contact, threats of physical harm, or acts of aggression.Property Damage: Intentional damage or misuse of venue, association, or member property.Substance/Policy Violation: Illegal drug use, excessive intoxication, or smoking in prohibited areas.

Impact & ScopeImmediate Safety Risk: The incident posed an immediate threat to the physical or emotional safety of one or more individuals.Disruption to Event: The incident forced the suspension of gameplay, required the organizer to stop an event, or caused a scene that impacted other attendees.Third-Party Involvement: Venue staff, local business owners, or external parties were alerted or involved due to the conduct.Vulnerable Participants: The incident involved minors, elderly participants, or other potentially vulnerable community members.

Witnesses(List names and contact information, if available)

Initial Action Taken(e.g., Party asked to leave, de-escalation attempted, police called)

Reporter signature & date

To be completed by the Incident Assessor

Is this a Repeat Offense? *The individual involved has had previous documented conduct issues.YesNo

Severity Level (Recommended Classification)Level 1 (Minor): A minor breach of sportsmanship or etiquette; easily resolved via conversation/verbal warning.Level 2 (Moderate): A repeated or significant breach; requires a formal warning or temporary suspension.Level 3 (Severe): A major breach involving harassment, discrimination, violence, or illegal activity; warrants immediate suspension and potential permanent expulsion.

Explanatory notes from Incident Assessor

Incident Assessor Signature & Date

Submit