Please enter your name (don't worry, your name can be kept private and not used in the story if you prefer - option for that appears below)
This is only necessary if we need to call you to get more details (if you chose that option below)
If the location you are referring to has a website and you know it, please enter it here.
Explain what happened in as much detail as possible. Please Make sure to include specific places and times.
If there are comments or notes related to your tale that you wish to share with the author(s) that will help provide background detail/etc, please enter them here
This is the legal mumbo-jumbo bit that is basically you saying "go ahead and use this info in the book - I'm good with that" and that you didn't make up what you shared above or that what you are sharing isn't violating any privacy agreement you have previously made.