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Report Health & Safety Incident

Lost Child Report

Date*

Day

Month

Year

Time In*

Time

:HoursMinutes

Report written by

Name & Job Title*

Person who delivered the child

Name*

Phone*

Address*

Email*

Location where child was found*

Child Details

Name*

Gender*

Ethnicity*

Age*

Hair colour*

Eye colour*

Mobile number (if applicable)

Clothing*

Top

Skirt/pant

Footwear

Hat/other

Caregiver/parent details

Name*

Phone*

Email

Address*

ID Type*

ID Number*

Relationship to child

Signature(s) of caregiver

Signature(s) of responsible event staff

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