WELFARE CONCERN FORM
Please use this form to report incidents
Name:
First Name
Last Name
Date of incident:
Age group of teams involved:
Please Select
U7
U8
U9
U10
U11
U12
U13
U14
U15
U16
U17/18
Your position in the club:
Please Select
WELFARE OFFICER
COACH
CLUB OFFICIAL (secretary,chairman)
PARENT
PLAYER
OTHER
Have you spoken to the the Welfare Officer of the alledged offending club?
YES
NO
SOMEBODY FROM THE CLUB HAS
Have you spoken to a referee?
YES
NO
NOT CONCERNING A MATCH
SOMEBODY FROM MY CLUB HAS
Is this concerning a club of a league committee member?
ASPIRE (Stephen)
FURZEDOWN LIONS (Natalie)
SPORTING DUET (Dave)
WESTSIDE (Jane)
NO (complete the box below)
If you answered no please can you complete your concern info in the box below:
If your answer was YES to a committee members club please email:
SECRETARYLCSYFL@GMAIL.COM - LEAGUE SECRETARY JOSHUA DA COSTA
Thank you for raising this with the league
We will confirm receipt of this complaint within 72 hours.Our process is: Confirmation of welfare concern as per FA guidelines,Confirmation of if League or county are to deal with the issue, Compiling report from referee, Gathering statements from witnesses, Deciding on appropriate course of action, which could include but is not limited to, immediate suspension, informal action, implementing mandatory educational courses, recommending a case to be raised by disciplinary committee, contacting relevant external agencies. We will aim to have this completed and communicated within 30 days but there maybe occasions this is not possible due to situations outside our control however we will keep clubs updated on a case by case basis
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