Report a Safeguarding Concern
Anything reported will be dealt with by our Safeguarding Team. We will properly record and report any abuse that we discover or suspect. If you have a concern or incident you wish to disclose to the Safeguarding Team, please complete the form below.
Name of person reporting the incident:
*
First Name
Last Name
What is your connection to Nene Valley Vineyard
*
Please Select
Staff Member
Church Member
Volunteer
Member of General Public
Your Contact Email Address
*
example@example.com
Your Contact Phone Number
*
Tell us Who or What your concern is about
Please provide as much detail as you can.
Child/Adult's Name (Their Name)
*
Their Date of Birth (if known)
-
Month
-
Day
Year
Date
Ministry Area/Group
*
Please Select
Kids/Youth
Dot to Tot
Adults/General
Other (please state below)
If 'Other', please specify:
Tell us about the concern or incident
Please give as much detail as you can at this time.
What is the concern or incident and why do you think it needs action
*
Where did it take place?
*
Who saw it and reported it?
*
Date of Incident
*
-
Month
-
Day
Year
Date
Time of incident on selected date
*
Hour Minutes
AM
PM
AM/PM Option
Please confirm:
*
I confirm that the information I have included in this form is, to the best of my knowledge, accurate and I hereby give permission for Nene Valley Vineyard to make contact with me on the number provided if further clarification about this incident is required.
Privacy Policy (view at https://nenevalley.church/privacy-policy)
*
I have read, understand and accept your data and privacy policy
Submit
Should be Empty: