*1.Your Full Name:(Required.)

*2.Your Contact Details (Email and/or Phone Number):(Required.)

*3.Have you raised this issue previously with anyone at the Club?(Required.)

*4.Date of the Incident(s) Related to Your Grievance:(Required.)

5.Location/Setting Where the Incident(s) Occurred:

*6.Please provide a detailed description of your grievance:(Required.)

*7.Are there any witnesses or individuals involved that you would like us to be aware of?(Required.)

*8.What outcome or resolution are you hoping for?(Required.)

*9.Are you submitting this grievance as a player, parent/guardian, coach, volunteer, or other?(Required.)

*10.Important Notice Regarding Your Grievance Submission and Process: Please be aware that by submitting this grievance, you confirm that the information provided is true and accurate to the best of your knowledge. Submitting a grievance containing false, misleading, or malicious information may be considered a serious breach of the Club’s code of conduct and could lead to disciplinary action in accordance with the Football Association of Ireland (FAI) and District Disciplinary Supervisory League (DDSL) regulations. All parties involved in the grievance will be invited to attend a formal meeting. A notetaker will be present during this meeting to ensure a fair, transparent, and accurate record of the discussion. This process is designed to support a thorough and impartial resolution, aligned with FAI and DDSL best practices. By typing your full name below, you acknowledge and agree to this statement and the grievance process:(Required.)