Confidential Concern & Complaint Form

Private & confidential

Concern & Complaint Form

Use this private form to raise a concern, complaint, safeguarding issue or child-welfare matter with Ardagh United. Give factual information and only include what is relevant.

Immediate danger?If a child is in immediate danger, do not wait for a response from the club. Contact An Garda Síochána on 999 or 112 and contact Tusla without delay.

1 About you

You may report anonymously. Providing contact details can help the safeguarding officer clarify information.

Submit this report anonymously

Your name Email address Phone number Your relationship to the club or child

2 Who is affected?

If known, provide enough information to identify the child or person safely.

Child or person’s name / initials Age or year of birth Team / age group Parent / guardian name, if relevant

3 About the concern or complaint

Type of concern * How did you become aware? * Date of incident or disclosure Approximate time Location People involved or who witnessed it Describe exactly what you saw, heard, were told or are concerned about *Use clear, factual language. If a child spoke to you, record their own words as accurately as possible. Do not investigate or ask leading questions. What action, if any, has already been taken? What would you like the club to do? Who else has been informed? Is anyone in immediate or continuing danger? *

4 Supporting information

Optional. Upload only relevant evidence. Do not share or create additional copies unnecessarily.

Attachments Up to 3 PDF, JPG or PNG files; maximum 5MB each.

How this information is handled

Your report will be restricted to authorised safeguarding personnel and shared only where necessary to protect a child, comply with the law, or follow safeguarding procedures. Absolute confidentiality cannot be promised.

I confirm that this report is made honestly and the information provided is accurate to the best of my knowledge.

Submitting this internal club form does not replace reporting a child-welfare concern directly to Tusla, the FAI, or An Garda Síochána where required.