YFN – Ministry Report Form

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YFN - Ministry Report Form

This is strictly for accountability and liability purposes for those who are involved with incidents and/or sensitive information that have transpired during ministry.

Reporter Information
Name*
First Name Last Name
Email*
Phone*
Report
Name of Camper*
First Last
Select Week*
Witnesses*
If there are none please put N/A
Type of Information Disclosed (please select all that apply)*
- Past physical abuse
- Active physical abuse
- Past sexual abuse
- Active sexual abuse
- Active eating disorder
- Active self harm
- Active suicidal thoughts
- Active drug addiction
- Active Nicotine Addiction
- Other
Incident (Brief Description)*
Is this camper a male or female? *
- Male
- Female
Church/Group Name (If attending as an individual/not with a group, please input "N/A")*
Youth Pastor Name (If none, input "N/A") *
Youth Pastor Contact Number (If an individual, please put their parent/legal guardian's phone number)*
Does the Youth Pastor (or Parent) know about this situation? *
- Yes
- No
If present, did you talk to their Youth Pastor? (please make the effort to contact them immediately if it involves deliverance or abuse)*
- Yes
- No

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YFN - Ministry Report Form

Reporter Information

Report