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Report a Child Protection Matter

> About > Child Health & Safety > Report a Child Protection Matter

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Which type of report are you making?
What type of Incident?*
- Child Only
- Child / Child
- Child / Adult
- Adult Only
Click here to Report a Behavioural Matter or breach of Code of Conduct

Your Details
These are the details of the person making the report
Your Name*
Your Address*
Street Address Address Line 2 City State Post Code
Your Phone*
Your Email*
How would you be liked to be contacted?*
Tick which option(s) you prefer
- Phone
- Email

Your Details Cont.
Are you a member of Scouts NSW*
- Yes
- No
Your Membership Number*
Your Appointment*
Your Formation*
Your Region*
What is your relationship to the Youth Member / Child?*

About the 1st Youth Member / Child
About the Youth Member / Child
Name of the Youth Member / Child*
Approximate Age*
Approximate age of the Youth Member / Child at time of incident
Are they a member of Scouts NSW?*
Was the Youth Member / Child a member of Scouts at time of incident?
- Yes
- No
- Unknown
Youth Member Membership Number (if Known)
Their Formation (If Known)
Their Region (If Known)

About the 1st Youth Member / Child Cont.
About the Youth Member / Child Cont.
Parent / Guardian / Carer Information 1 (If Known)
Name of Contact 1
Address of Contact 1
Street Address Address Line 2 City State Post Code
Phone of Contact 1
Email of Contact 1
Relationship of Contact 1 to the Youth Member / Child?
Parent / Guardian / Carer Information 2 (If Known)
Name of Contact 2
Address of Contact 2
Street Address Address Line 2 City State Post Code
Phone of Contact 2
Email of Contact 2
Relationship of Contact 2 to the Youth Member / Child?

About the 2nd Youth Member / Child
Name of the 2nd Youth Member / Child*
Approximate Age*
Approximate age of the Youth Member / Child at time of incident
Are they a member of Scouts NSW?*
Was the Youth Member / Child a member of Scouts at time of incident?
- Yes
- No
- Unknown
Youth Member Membership Number (if Known)
Their Formation (If Known)
Their Region (If Known)

About the 2nd Youth Member / Child Cont.
Parent / Guardian / Carer Information 1 (If Known)
Name of Contact 1
Address of Contact 1
Street Address Address Line 2 City State Post Code
Phone of Contact 1
Email of Contact 1
Relationship of Contact 1 to the Youth Member / Child?
Parent / Guardian / Carer Information 2 (If Known)
Name of Contact 2
Address of Contact 2
Street Address Address Line 2 City State Post Code
Phone of Contact 2
Email of Contact 2
Relationship of Contact 2 to the Youth Member / Child?

About the Adult Involved in the incident
Name of Adult*
If you do not know the name, write Unknown
Are they a Member of Scouts NSW?*
- Yes
- No
- Unknown
Membership Number (If Known)
Formation of the Adult (If Known)
Region of the Adult (If Known)
Any Other Information

About the Incident
Name of Scouting Event or Activity*
Location of Incident*
Region of the Incident*
Date*
Date Format: DD dash MM dash YYYY
Time (If Known)

: HH

MM
Description of Incident, Observations or Comments*
If you wish to upload a file with more information, please do so here

About the Incident Cont.
Names, Ages and any other details (If Known) of other Youth Members / children who are involved in this incident
Any other information you would like to add

Any Previous Reports
Has the incident been reported before?*
- Yes
- No
- Unsure
Who was the report given to?*
- Police
- Family & Community Services (FACS)
- Scouts NSW
- Scouts Australia
- Other Organisation
Name of Other Organisation*
Who reported to them?*
When was it reported?*
Date Format: MM slash DD slash YYYY
Any Reference number that have been provided
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call our CHILD SAFE HOTLINE ON

1800 605 004

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Downloads

Scouts NSW Code of Conduct and Code of Ethics
Child Protection Policy
Child Protection Procedure
Child Safe Messaging, Major Events Protocol
Parents' Child Protection Guide
Social Media Guidelines
SANSW Working With Children Checks Procedure

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Report a Child Protection Matter
Report a Behavioural Management Matter or
Breach of the Code of Conduct
Report a WHS or Health Matter

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