Firesetters referral form - Legal guardian

Consent

The agreement and support of the legal guardian is crucial to the success of the programme.

I confirm I am the legal guardian of the child/young person detailed within this referral.

If you would like to discuss the referral in more detail please contact the Firesetters team:

Phone: 0117 926 2061 Extension 8269
Out of hours voicemail: 0117 926 2061 Extension 393
Email: Firesetters@avonfire.gov.uk

If you are not the legal guardian of the child/young person you are referring please complete our ‘I am not the legal guardian’ form by clicking here.

Your details

First name

Surname

Your address and postcode

Telephone number

Alternative telephone number

Details of child/young person

First name

Surname

Date of birth (DD/MM/YYYY)

Age

Gender

Address of young child/young person if different to legal guardian above.

Referral information

Reason for referral

Firesetting history

Are there other agencies working with the referred child/young person?

Yes

Not known

Avon Fire & Rescue Service is committed to serving the local community, ensuring a safer place for people to live, work or visit. We are also committed to complying with the EU General Data Protection Regulations (GDPR) and the Data Protection Act 2018 (DPA).

Avon Fire & Rescue Service will collect, process and hold the personal information supplied within this form in order to provide public services associated with that of a fire & rescue service.

Avon Fire & Rescue Service will only share information about children and young people where the law and our policies allow us to do so. We have a responsibility to promote social wellbeing and prevent harm therefore we have a duty of care to pass on information such as where a child is at risk of harm (for safeguarding purposes) or when a criminal activity has been disclosed.

More information can be found on the Privacy and Cookies pages by clicking here and specifically regarding Firesetters by clicking here.

I confirm I have read and understood the Terms and Conditions above.

Our plans and strategies

Read our Service Plan here

Underpinning our Service Plan are our three core strategies:

Did you know?

You're twice as likely to die in a fire if you don't have a smoke alarm that works.