Lancashire FA | Report A Safeguarding Concern or Incident

Lancashire FA | Report A Safeguarding Concern or Incident

Use this form to report any instance where you consider a child, young person or adult at risk to have been harmed or be at imminent risk of harm.

These are serious concerns / incidents where the concern is associated with football-related activity.

Your full name*

Please give us your full name.

Current football roles*

Please let us know of any football roles you currently hold.

Select or enter value

Email address*

Please also let us have your email for contact purposes, including confirming receipt of your submission.

Date of concern / incident*

Venue where concern / incident occurred*

Name of Club / League involved*

Name of individual(s) whose behaviour has given cause for concern*

Description of concern / incident*

Please provide full details of the safeguarding concern you wish to make, please be as descriptive and factual as you can. If there was any foul language used please write this in full and don't star out any letters or words.

Please also indicate the date, time and location that this incident took place, and details of where you were and how you know about this occurring.

If you don't have enough space, or wish to add further supporting statements or photo evidence, you will have the opportunity to upload files at the end of the form.

Has this been reported to the Club or League?

Yes - reported and investigation underway

Yes - reported and investigation concluded

Unsure

Supporting evidence

Please use this area to add further supporting statements or photo evidence.

Drag and drop files here or

Send me a copy of my responses

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