This form should be used to record any safeguarding or welfare incident or concern that is brought to your attention. Details should be recorded as soon and as accurately as possible.
Remember to maintain confidentiality on a need to know basis. Only disclose information if it will protect the child.
All fields are required unless otherwise stated.
Please complete your details as best you can
Optional.
Optional. If you don't know then leave blank
Optional. My own concerns
Optional. Name, email, position in club and contact number if possible
Please provide details below
Please provide as much information as possible
Optional. Name, number, date, details of advice
Please click the box to indicate you are a human rather than an automated system completing this form.
Please ensure all fields are completed as accurately as possible before submitted.