Safeguarding - report a concern

Person registering a concern *

First Name

Last Name

Child/Adult's name *

First Name

Last Name

Child/Adult's date of birth

MM

DD

YYYY

Confirmation from you *

I confirm that the information I have included in this form is, to the best of my knowledge, accurate and I hereby give permission for Severn Vineyard to make contact with me on the number provided if further clarification about this incident is required.

Privacy *

Please read how we handle personal data at https://www.severnvineyard.org/privacy-terms

I accept that you will handle personal data from me in accordance with the Privacy & Terms described at https://www.severnvineyard.org/privacy-terms