Resident Damage Report

"*" indicates required fields

Full Name*

Email Address*

Mobile No*

Are you a member:*

Yes

Unit No

Street No*

Street Name*

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Suburb

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State

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Postcode

When were you aware of the damage?*

if known, when did you become aware of the issue

Time of Incident*

Description of Damage*

Was anyone injured or involved?*

Upload Photos (damage, ball, etc)*

Drop files here or

Max. file size: 2 MB.

Required, photos of damage - Minimum 3 photos

Have you previously reported a similar incident?*

Yes

Are you seeking assistance in repairs?*

Preferred Contact Method*

Phone

Damage may need to be inspected by GCCC or Authorized Representative prior to repair or modificaiton

1. Brand/Make Model*

2. Ball No*

3. Other Markings

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Name

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