Amusement Ride and Attraction Safety Complaint Form

Submit A Complaint

* indicates required field

Name

(Optional)

E-Mail

(Optional)

Date of Activity

When did the activity take place (date)?

Time of Activity

When did the activity take place (time)?

Activity Reported

What suspicious or unsafe activity took place?

Company In Question

Who is the Amusement Ride or Carnival Company?

Ride or Attraction Name

What Amusement Ride or Attraction did the activity occur on (name of ride or description)?

Location of Activity