Concern FormUse this form to report any safeguarding concerns you might have Your Details * First Name Last Name Email * Phone (###) ### #### What is your connection to The River Church? * Volunteer Church member Member of the public Today's Date * MM DD YYYY Tell us about your cornern * Child/adult first and last name First Name Last Name Child/adult date of birth If you don't know just leave this blank MM DD YYYY Child/adult address If you don't know just leave this blank Ministry area or group * Kids Home groups Other What is the concern or incident and why do you think it needs action? * Please provide as much information as you can including names, times and dates. Be as specific and as factual as possible, do not include personal opinion. What date did this take place? * MM DD YYYY What time did this take place? Hour Minute Second AM PM Where did this take place? * Who saw and reported the incident? * What action was taken and who else has been informed? * Thank you for taking this seriously and helping us ensure everyone at The River Church is loved and protected. This form has been sent directly to the safeguarding team who will process and action this as appropriate. IIf you have any questions please contact Cheryl the safeguarding lead at cheryl@theriverchurch.co.uk
