S25 Camp Safeguarding Report Form

Camp Safeguarding Report Form
If you have been asked by a member of the Head Office Safeguarding team to complete this form please do so with as much detail as possible. Copy all information recorded by staff on the original incident form so if needed, our Head Office team can share this information accurately with outside agencies.

This form should be completed in conjunction with a phone call to our Designated Safeguarding Lead (El Ciccotti) or Deputy Designated Safeguarding Leads (Dave Matthews or Sophie Sibbald).

Camp Hotline 01865 513 111

Option 4 - Safeguarding
I can confirm I have discussed this incident/concern with a member of the UAC head office safeguarding team (This form should not be completed before that conversation)*

YesNo
Name of the person in the safeguarding team I discussed this with.

First NameLast Name
Name of Person reporting concern*

First NameLast Name
Please select your location*
I can confirm I completed the paper copy of this incident/concern.*

YesNo
I can confirm the paper copy of this incident/concern is stored in the relevant place on camp (Archiving Box).*

YesNo
Date of Incident/Concern*

MonthDayYear
Date
Time of Incident/Concern*

Hour Minutes

AM/PM Option
Who is the concern regarding?*

UAC StaffChildContractorSchool StaffOther
Other: (Please state)
Name of Person Concerned*

First NameLast Name
Age - If known (N/A if not known)*
Location of Incident or Concern*
Description of Incident or Concern*
Action Taken*
This information will be shared with the Head Office Safeguarding team only. If you have any further concerns please ring the safeguarding number through the Camp Hotline and detail any further information recorded by submitting another form.

The original incident forms should be stored securely in your archiving box and a member of the team will collect them.
Head Office Actions

The following section is for Head Office use only.
DSL / DDSL Name

First NameLast Name
Referred to LSCB / LADO

YesNo
Reason for decision behind whether to refer or not. Outcome or Further Action.
Should be Empty:

Camp Safeguarding Report Form

Head Office Actions