GV Child Safe Reporting Form

Gymnastics Victoria Child Safe Report Form

If you or a child you are concerned about is in immediate danger or their life is at risk, please call the Victorian Police on 000 immediately.
Gymnastics Victoria has experienced and trained staff including a dedicated Child Safe Coordinator, who will read your report and determine the next steps to be taken.

If you require assistance or would like to talk to a trained professional about the issues you are worried about, please call Kids Helpline on 1800 55 1800 or Lifeline on 13 11 14. If you believe a child is in immediate danger please call Police on 000

Thank you for visiting our online reporting tool. Please select from the options below
Do you want to talk to the Child Safe Coordinator at Gymnastics Victoria about what is worrying you? *

Yes No Not Sure
As well as speaking with someone from Gymnastics Victoria, do you want to fill out an online report as well? *

Yes No

What would you like to do? *

I want to continue with this online form to make a report I want to find out more about what Gymnastics Victoria will do with this information I want to see information on understanding the risks of harm to a child as well as making a report to Child Protection or the Police
About us

Gymnastics Victoria is a child safe organisation and has a zero tolerance for child abuse. Child Safety is our highest priority. We are committed to promoting and protecting the interests and safety of all children and young people in our sport.

What is Child Abuse?
- In Victoria, under the Children Youth and Families Act 2005 a child or young person is a person under the age of 18 years.
- Child abuse is an act by parents, caregivers or others which hurts or puts at risk a child or young person's physical, emotional, psychological, or development health. Child abuse can be a single incident, or something that happens over time.
- The types of abuse includes: Sexual abuse, Physical abuse, Psychological/ Emotional abuse, and/or Neglect
- If you feel a child is not safe, please fill out the form below.
Who sees the reported information?
- Gymnastics Victoria has experienced and trained staff including a dedicated Child Safe Coordinator, who will read the reports and investigate further. These people are the ones that will see what you have written.
What is done with the information?
- The information will be securely recorded and if the report is of a serious nature, Child Protection or the Victorian Police will be informed by Gymnastics Victoria. (insert link to our process resolution map)
Do I have to give my name?
- No, you do not have to give your name, you can make a report anonymously however under the Children, Youth & Families Act 2005, a reporter's details are kept confidential. Providing your name will assist us in investigating the report.
Who can complete the form?
- Anyone can fill out this form: children and adults are encouraged to report any concerns.
- You can complete this form if you wish to report a child protection matter or if you prefer you can contact the Gymnastics Victoria office on 03 9005 4700 and speak with the Child Safe Coordinator or one of GV's trained staff .
If you believe a child to at immediate risk of harm, call Victoria Police on 000.

To report concerns about the safety of a child within their family unit, call the Child Protection Emergency Service on 13 12 78 (24 hours, 7 days a week, toll free within Victoria). Note: this is an emergency service for weekends and after hours only however they will pass on information to the relevant Child Protection office the following working day
For further information, please click here.
Your age *

I am under 12 years old I am between 12 - 18 years I am over 18 years

Tell us about what is worrying you.
Who is this about? *

Me Someone I know

Tell us about yourself.
What is your name? *

First Name Last Name
How old are you? *
What is your date of birth?
What gymnastics club do you go to? *
What is the name of the person that worries you?

First Name Last Name
How do you know this person?
What is this person doing that worries you? *
Has it happened more than once? *

Yes No
When and where does this happen? *
What do you want Gymnastics Victoria to do about this? *
Is anyone helping you fill out this form ? *

Yes No
What is the name of the person helping you fill out this form ? *

Tell us about what is worrying you
What is the name of the person you are worried about *

First Name Last Name

Do you know where they live or what school they go to? If so please write their address or the name of their school

Street Address

Suburb	State
Postcode	Country

How old is this person? *
What grade are they in at school?
Please tell us why you are worried about this child/young person *
How do you know about this?
When and where did this happen? *
Do you know the name of the person that is hurting the child or young person
What is their name?
Do you know this person? How?
What is this person doing that worries you? *
What do you want Gymnastics Victoria to do about this? *
Is anyone helping you fill out this form? *

Yes No
What is the name of the person helping you fill out this form? *

Your contact details
Please fill in all the contact details you are comfortable supplying. We will keep this private, but we may need to contact you to discuss your concerns. This will be confidential.
Name

First Name Last Name
Email (If you do not have an email account ask your parents or a trusted adult if you can use their email address.) *
Home Phone Number
Mobile Phone Number
Best time of day to contact you

Can Gymnastics Victoria contact you about this information? *

No Yes - please contact me Yes - But I want to remain anonymous Not sure
Is there any other information you would like to tell GV?
Thank you for taking the time to fill out this form. All reports regarding child protection are treated in strictest confidence and taken very seriously.

If you require assistance or would like to talk to a trained professional about the issues you are worried about, please call Kids Helpline on 1800 55 1800 or Lifeline on 13 11 14. If you believe a child is in immediate danger call Police on 000
Should be Empty:

Gymnastics Victoria Child Safe Report Form

Tell us about what is worrying you.

Tell us about yourself.

Tell us about what is worrying you

Incident Report

Child or Young Person's details

Details of the person you think may be harming a child or young person

Your contact details