GRIEVANCE COMPLAINT FORM
(continued on next page)
This form shall be submitted to New Jersey Youth Soccer by a member (e.g., player, coach, board member, club, league) who seeks
formal action against another member. Members must first exhaust the grievance process(es) afforded to them by the member with
original jurisdiction (e.g., club and/or league).
Filing Date:__________
COMPLAINANT:
Full Name:_________________________________________ Email:_____________________________________________
Phone Number: ________________________ Club/League Affiliation: __________________________________________
ON BEHALF OF:
(Only complete this section if the grievance is being filed on behalf of another individual [e.g., a parent/guardian for their child]).
Full Name:_________________________________________ Email:_____________________________________________
Phone Number: ________________________ Club/League Affiliation: __________________________________________
Team Name: _______________________________________ Team Age: _________________________________________
ACCUSED:
Name:__________________________________________________ in capacity [ ] as an individual / [ ] as an Organization
Name:__________________________________________________ in capacity [ ] as an individual / [ ] as an Organization
Name:__________________________________________________ in capacity [ ] as an individual / [ ] as an Organization
Dat
e(s) of the incident(s)/occurrence(s): _________________________________________
NJYS Member Organization of the Accused (if known): _________________________________
Team of the Accused (if applicable): ________________________________________________
Age Group(s) (if applicable): ______________________________________________________
DOCUMENTATION:
A. DO
CUMENTATION REQUIRED WITH THE GRIEVANCE FORM:
Þ Grievance Complaint Form completed, including the Verification (at the end of page 2) signed by the Complainant.
Þ Wr
itten Statement signed by the complainant. The Statement must detail the following:
i. The
precise NJ Youth Soccer, US Youth Soccer, and/or US Soccer policy document, policy section name,
policy number, and policy text that the complainant asserts was violated, and by whom; and
ii. The specific event(s) and circumstances, that establish the violation(s), including names, dates, locations,
conduct, etc.
Þ Additional Supporting Documentation (if any), that the complainant believes is relevant to the allegations raised.
All emails, texts, and/or photos should include dates whenever possible, and must be submitted in PDF format
attached to the Grievance Complaint Form.
Þ Filing Fee made payable to New Jersey Youth Soccer in the amount of $300 via cashier’s check or money order and
submitted via mail, and which may be returned upon discretion of the Discipline & Appeals Committee.
This form and the required documentation shall be submitted to via email to NJYS Discipline & Appeals Committee Staff Liaison, Ryan Foley
(ryan@njyouthsoccer.com).
Your Grievance Complaint Form, Statement, Additional Supporting Documentation, and Filing Fee are the sole
basis used in an initial screening process by D&A to determine the jurisdiction and merit of your complaint. Provide
a clear, complete explanation and supporting evidence.
This Grievance Complaint Form, with supporting documents, must be submitted together in PDF format as a single
PDF file.
B. ADDI
TIONAL DOCUMENTATION to be submitted to NJYS for the Discipline & Appeals Committee at least seven (7) days
prior to hearing date, unless otherwise specified in the Notice of Hearing:
Þ REQUIRED: List of Witnesses (if any): Written list (submitted in PDF format) of the Name, Phone number, and (if
possible) the email address, of each and all witness(es) that you may present during the Hearing.
Þ OPTIONAL: Witness Written Statements: You may provide written up to three (3) Witness Statement(s) from
individuals, describing their direct knowledge of pertinent events in sufficient detail, including date(s), location(s),
and parties involved in the event(s).
i. Each Witness Statement must be dated and signed, in PDF format, and include email and phone# contact
information.
ii. If a witness then is not available for the Hearing, their written Witness Statement may be considered by
the D&A panel, in its discretion, but that evidence may be accorded less weight than if it had been give
n
th
rough live testimony.
Þ OPTIONAL: Supplemental Documents (if any): Must be submitted in single file, PDF format.
i. Any supplemental information presented after the above-stated deadlines, may be declined/excluded, a
t
D&
A panel’s discretion.
PROCESS:
A. After a Grievance is duly submitted, it will be screened (Initial Screening Review) to determine whether the matter falls
within the jurisdiction of the NJYS Discipline & Appeals Committee, identifies applicable Policies, and has merit.
B. If the Initial Screening Review determines that these criteria are met and the matter warrants further process, a Notice of
Grievance will be sent to the accused (and copied to the Complaining party).
C. The accused then is entitled to timely Respond, and to receive the following information prior to any Hearing, to have th
e
tools and time in which to mount a defense:
Þ Copies of all materials submitted to and accepted by the D&A Committee (e.g., Grievance Complaint & supporting
documentation); and
Þ Names of all individuals who may or will be giving testimony against the accused (i.e., List of Witnesses).
D. The parties will be provided a Notice of Hearing, specifying the date, time, and place to appear for a Hearing before a D&A
panel.
NOTE: The Discipline & Appeals Committee does not act as an accusatory or investigatory body. YOU ARE RESPONSIBLE FOR
PROVING YOUR CASE. You are responsible for arranging for witnesses to present evidence supporting your claim. You are
responsible for duly providing the Committee with all the evidence and information you think will be necessary. Evidence,
information, documentation, or witnesses not first presented until after the advance specified deadline, or first presented at the
Hearing, may not be allowed or permitted, as determined by the D&A Panel.
The Appellant will submit a [ ] Cas
hier’s Check / [ ] Money Order in the amount of $300 to New Jersey Youth Soccer
VERIFICATION & SIGNATURE OF COMPLAINANT (REQUIRED):
I hereby certify this Grievance Complaint Form, Statement, and any Additional Supporting Documentation is true, and together with
appropriate fee in the amount of $300 (in the form of a cashier’s check or money order), made payable to: NEW JERSEY YOUTH
SOCCER, has been sent to:
_______________________________
Complainant Signature
New Jersey Youth Soccer
Attn: Discipline & Appeals Committee
3 Paragon Way, Suite 400
Freehold, NJ 07728
_______________________________
Date
