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Investigation Request

Please fill in the form below

First Name*

Middle Name

Last Name*

Date of Birth*

Email*

Gender

Male

Female

Other

Please upload a photo of your ID

Description of incident to be passed onto venue management. Please be specific with dates, times, locations, and other details:

Has the venue been contacted?

Yes

No

Personal information from this form is used only for investigating a patron record or flag. Unless required by law, this information will be deleted in 21 days.