AAC Incident Report

Agility Association of Canada
Trial Report - Used to file a Report or Lodge Official Complaint
Host Clubs and Judges are REQUIRED to fill out this Report, one per Trial, Regardless if no incident took place, in order to confirm that fact.
TRIAL REPORT (with)
Please use/fill in as much of the information as possible, sign and send to: admin@aac.ca
- The identity of the reporting party will be known to the discipline committee in every case and will generally be disclosed, in accordance with procedural fairness, to the other parties to the incident, including the alleged violator. The discipline committee may, in its discretion, make an exception to disclosure where a reporting party makes known to the discipline committee circumstances which give rise to a reasonable expectation by the reporting party of a threat to his or her safety, security or physical or mental health, or otherwise in accordance with law.
- Person
  Person filling in this Statement (you are not required to be an AAC member)
- Name:
- Your position?
- Your signature
- Date:
  DayMonthYear
  1
- Address
  Street Address
  Street Address Line 2
  CityProvince
  Postal Code
- Phone
  Format: 000-000-0000.
- Cell
  Format: 000-000-0000.
- Email:
  example@example.com
- Event hosted by:
- Event name/Trial dates:
  MonthDayYear
  Date
- If this is a Trial Report with no incidents; CONFIRM and Stop filling in here.
- The DC can dismiss a complaint in the early stages of an investigation if it is determined that it is without merit, frivolous, insubstantial or an abuse of process. Filing a frivolous or abusive complaint is itself grounds for discipline.
- Incident Occured
- Date of incident:
  DayMonthYear
  2
- Brief description of the alleged violation: (Fill in details on page 2
- General Info.
  Other
- (Examples: Trial site or equipment unsafe or do not meet AAC specs)
- Section for AAC Administration
- Report sent to
  DC, JSAC, BoC, AAC Records only
- Date filed/received:
  DayMonthYear
  3
- Incident ID #
- Anyone witnessing any act of abuse or aggression may fill out an Incident Report / lodge a complaint. For AAC representatives, Trial committees, Judges, it is not only our responsibility but our duty/obligation to report incidents to improve safety/ airness at AAC events.
- Please note that in accordance with AAC policy, parties alleged of a violation are not permitted to contact the party completing the incident report, or any witness to the incident, for the purpose of harassing, intimidating, bullying or otherwise discussing the incident in a threatening or coercive manner. The discipline committee may, in its discretion, orchestrate discussion between the parties as a means of resolving certain disputes or incidents.
- Alleged Parties Name
  (Dog owner, handler, host club or organization)
- Alleged Party
  Other
- SECTION IV – Specific Information (if applicable)
- Location of incident: ( In the ring, benching area, passage way, parking, waiting / warm up area, in/out gate, other);
- Approximate number of witnesses :
- Judge in the ring (if during a run):
- Class/level/run:
- SECTION V – Detailed description of events
- Include all Facts on who, what, where and when (Details are important)
- I have attached a detailed account
- The day of the event; the alleged violator:
- The day of the event; the alleged violator:
- What sanction was imposed at Event :
- Other relevant information:
- Anyone witnessing any act of abuse or aggression may fill out an Incident Report / lodge a complaint. For AAC representatives, Trial committees, Judges, it is not only our responsibility but our duty/obligation to report incidents to improve safety/ fairness at AAC events.
- Reserved for Administration
- Reserved for Administration
- SECTION VI – Diagram
- Files uploaded - docs, images or video
- Position all parties involved, distances if possible
- SECTION VII – Possible witnesses of the incident (As many as possible)
- Names: Spectators, Volunteers (Judge, gate steward, scribe, timer, other) Contact (email, phone)
- SECTION VIII – People I informed of the incident
- Name :
- Name :
- Name :
- Trial Secretary
- Name :
- Trial Chairperson
- Name :
- Trial Organizing Committee
- Name :
- Name :
- Anyone witnessing any act of abuse or aggression may fill out an Incident Report / lodge a complaint. For AAC representatives, Trial committees, Judges, it is not only our responsibility but our duty/obligation to report incidents to improve safety/ fairness at AAC events.
- The following is only applicable if this is a dog related incident:
- SECTION IX – Alleged Violator- Dog Information (If information available)
- Dog’s name :
- AAC Dog ID#:
- Approx Weight
  lbs.
- Approx Age:
  Yrs.
- SECTION X – For dog aggression related incident
- Was there contact made:
- Determined how :
- Were there any injuries:
- Were there any injuries:
- Name of victim(s):
- Extent of injuries:
- Treatment required by veterinarian or physician:
- Other relevant details:
- SECTION XI – All other dogs involved in incident (if applicable)
- Dog’s 1 name
- Approx Weight
  lbs..
- Approx Age
  yrs.
- Owned by :
- Dog’s 2 name :
- Approx Weight
  lbs.
- Approx Age
  yrs.
- Owned by :
- Dog’s 3 name :
- Approx Weight
  lbs.
- Approx Age
  yrs.
- Owned by :
- Note: The size and age are useful in order to better understand of the incident.
- For example, a 15 lb dog leaves the ring to chase after a 60 l b dog: The 15 lb dog repeatedly grabs at the larger dog's legs, making contact several times, and avoids attempts by the handler to catch and restrain it. The larger dog tries to evade the smaller dog, but eventually does react, biting the smaller dog and causing a minor wound. In this scenario, even though the smaller dog was injured and the larger dog was not, the Committee would most likely find that the smaller dog should be penalised (initiated the incident, multiple attempts to bite) and the larger dog should not (was not the aggressor, attempted to avoid the smaller dog, showed some degree of bite inhibition, and was clearly provoked Anyone witnessing any act of abuse or aggression may fill out an Incident Report / lodge a complaint. For AAC representatives , Trial committees, Judges , it is not only our responsibility but our duty/obligation to report incidents to improve safety/ fairness at AAC events.
- AAC_Trialreport-Incidentcomplaint Last reviewed: December 10, 2012
- Should be Empty:

Agility Association of Canada

Person

Incident Occured

Section for AAC Administration