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Speed Stacking Professional Society of Kenya
Safe Stacks · Child Safeguarding for Coaches · with NextGen Learners Hub
Safe Stacks · Form · version 1.0

Concern Record

Write down what you saw or were told, in plain words, then give it to the Focal Point only.

Draft for approval by the SSPSK Board.

How to use this

Complete it within the first two hours, before the details fade. Write facts: what you saw, what was said, in the child's own words where you can. Do not write what you think it means, and do not add anything you were not told.

This form stays on your device. Print it or save it as PDF and give it only to the SSPSK Safeguarding Focal Point (Gilbert Kipkemoi Kiprop; contact details are being confirmed by SSPSK). Do not email it around or post it in a group. Then delete your copy.

Remember

You do not investigate. You do not promise secrecy. You call the Focal Point the same day.

Fill this in here, then print it or save it as PDF. Nothing you type is sent to or stored by this website.

When and where
The child
What happened
What you did
About you

This is an accurate record of what I saw and was told.

1 November 2026
Signature
Date

For page numbers on every page, choose Margins: Default in the print dialog (under More settings).