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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*
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?*
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

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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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