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Initial Issue/Concern Reporting Form

Please provide information on this form, if you have a concern or an issue relating to someone or something at your rugby club.
Name of child/adult :


Age/Date of Birth:

Club: Drifters RFC

Age Grade:
What is the concern? (include details of the person whose behaviour has raised concerns)

When and where did this concern/incident occur?

Do you have any other comments?

Your name:


Club Role:


Email address:

Mobile Phone No:

Use of the Initial Issue/Concern Reporting Form
What should be reported?
The welfare of the child is paramount. In order to assist the RFU and your club in upholding this principle you are asked to complete the form for any issues/concerns or incidents. When completing the form please give full names and their club roles. Concerns may be about the behaviour of any child or adult involved or spectating at your club and could include:
♣ General concerns about a child’s welfare
♣ Concerns related to a safeguarding incident eg bullying or poor practice
♣ Concerns, Suspicions or allegations of misconduct
♣ Breaches of the RFU Core Values or your club Code of Conduct
♣ Allegations of abuse made by or against any child or adult
If you would like further details of what should be reported please refer to the RFU Safeguarding Policy, Procedures and Guidance which can be found on Safeguarding pages of the RFU website
To discuss a specific concern or issue please contact your Club Safeguarding Officer or your Constituent Body Safeguarding Manager in the first instance.

Please send this form to your Club Safeguarding Officer, your CB Safeguarding Manager and
the RFU Safeguarding Team at

Where next?

Safeguarding Policy Drifters Rugby Football Club Safeguarding Policy 1.Drifters Rugby Football Club acknowledges i


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