Confidential Safety & Conduct Reporting

Incident & Safety Report

Rainier Clatskanie Youth Soccer Club is committed to maintaining a safe, respectful, and positive environment for all youth players, volunteers, referees, and families. Use this form to report injuries, field or facility hazards, code of conduct violations, or safety concerns.

Immediate Life Safety or Medical Emergency?

If someone requires immediate medical attention, or if there is an active threat to personal safety or property, please call 911 immediately. Do not rely on this web form for active emergencies. For urgent club board contact during match days, you may also call or text our 24/7 hotline at (877) 804-2059.

Anonymity & Privacy

You have the right to submit this report completely anonymously. If you choose to remain anonymous:

Your name, email address, and telephone number will not be recorded in our database.
Club leadership will investigate the circumstances based entirely on the factual details provided.
Please provide as much specific factual information (dates, locations, team names, witness accounts) as possible to aid thorough follow-up.

If you choose to provide your contact details, our safety officers will maintain strict confidentiality and only contact you for clarification.

Report Categories

Field & Facility Hazards Unanchored goals, deep turf ruts, broken glass, hornets/bees, or locked facilities.

Injuries & Concussions Severe on-pitch player collisions, suspected head injuries, or ambulance dispatches.

Conduct & Harassment Spectator unsportsmanlike conduct, verbal abuse of youth referees, or bullying.

Need General Assistance?

For registration inquiries, roster updates, or general feedback not related to safety or incidents, please use our general contact form.

General Contact Page

Incident Report Form

Please fill out the details below. All fields marked with an asterisk (*) are required.

Submit Anonymously Toggle this ON if you do not want your personal name, email, or telephone associated with this report.

Your Contact Information

Your Full Name *

Email Address

Phone Number

Relationship to Club

Incident Category *

Urgency Level *

Incident Date & Approximate Time *

Location or Field Name *

Involved Individuals or Teams (Optional)

Witnesses (Optional)

Immediate Action / First Aid Taken (Optional)

Detailed Description of Incident *

Minimum 15 characters

Data handled in accordance with RCYSC Safety & Privacy policies.