FNSW Kids Feedback Form

KIDS FEEDBACK FORM
Hi,

Thanks for visiting our website and clicking on our feedback form. This is a great way of getting information to us. We know sometimes that kids don't like talking about some things, so please use this form to tell us instead.

If you are a child and are being harmed or hurt by someone or someone is making you feel unsafe, please let us know by using this form or please tell your Teacher or a Doctor or another adult that you can trust.

To use this form there are a couple of things to know before you start:
- If you see a question with a * - you need to type in an answer
- If there is no * next to the question - it is your choice if you answer
- The more information you give us, the better we can try and help.
Lets get going, it's really easy :-)
In your own words, tell us what the problem is*
Who is causing the problem?*
Type in the person's name or their role(s)
How long has the problem been happening?*
Have you told anyone else about it?*

Mum or Dadyour coach or managersanother person at the clubyour school teacheran Aunt or Unclea friendI haven't told anyone elseOther
Did they do anything to try and help?*

YesNoI don't knowthey spoke to someone at the clubthey spoke to the coachthey spoke to the person causing the problemOther
TELL US ABOUT YOU AND YOUR FOOTBALL

To be able to help, we need to know a bit about you too. The more you tell us, the more we can help. Please fill in as many of the questions below as you can.
What do you like about football? (tick as many answers as you like!)

PlayingHaving funMaking friendsStaying healthyScoring goalsMaking my family proud of meOther
How long have you been playing football?*

This is my first year1 - 5 yearsMore than 5 yearsMore than 10 yearsI'm not sureOther
What club do you play with?*
What is your name?
Are you a girl or a boy?*

GirlBoyOther
How old are you?*
E-mail
Enter your email address if you want us to contact you back
Phone Number
Enter your phone number if you want us to contact you by phone or text message
Feedback
Please give us any feedback or additional information here
Thanks for contacting us. Great job!

To finish, just click on the button below.
Further Information

This form is only for children and young people under 18 years of age.

To speak with someone at Football NSW, call me on 8814 4402 Monday to Friday between 9am to 5pm. Our discussion will be private and confidential.

This form allows children to share information with Football NSW about their safety if they are unable to discuss their concerns with a responsible adult or over the phone or by other means. Only forms submitted by a child will be considered. The more information provided, the more likely we are able to respond to the concerns raised. Parents and other adults are not permitted to use this form to lodge concerns. If a child raises safety concerns with a parent or adult, then that person is responsible for taking steps to manage or report those concerns with the relevant club, association, school, organisation or to Police, FACS or other relevant Government agency.

Where a child is at risk of harm from abuse or neglect, the NSW Kids Helpline is open 24 hours, 7 days a week and is answered by qualified persons who can assist children and adults with matters and concerns relating to harm, abuse or neglect of children and young people. Children or adults can call the Kids Helpline on phone 132 111.
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KIDS FEEDBACK FORM