Making Memories… Giving Hope

Refer a Child on a CHICKS Break

Refer a Child on a CHICKS Break

Do you work with a child who would could benefit from a CHICKS break?

Anyone that works with a child in a professional capacity can refer them for a five day residential respite break. 

Agencies that currently refer to us include Social Services, schools, youth groups, churches, Young Carers' groups and community centres amongst others.

Children must be aged between 8 - 15 years old. 

Children can be referred to CHICKS for a huge variety of reasons. They may be living in poverty, be young carers or be subject to neglect, bereavement, abuse, emotional distress or any other situation that causes the child to have a tough time at home.

For more information, including criteria for referral please check our FAQs. 

Referring a child

In order to refer a child, you will need to complete a break referral form and then arrange for the parents/guardians of the child to complete a consent and medical form which must be posted or scanned and emailed back to us. 

An online referral application must be completed for each individual child to enable us to assess their situation. It is important that children are referred by a professional person who is able to take responsibility for completing paperwork, arranging transport and being the primary contact, providing the link between the family and CHICKS. 

2017 Breaks

We are now accepting applications for children to attend our Spring 2017 breaks! If you made a referral in 2016, we will need a new referral application for that child. To apply:

View the available break dates

Complete a 2017 Break Referral Form

Download a 2017 Consent and Medical Form (to be completed by parents/guardians)

Help for Heroes Breaks

CHICKS and Help for Heroes have combined efforts to create respite breaks for children in 2017 of wounded, injured and sick service men and women. If you are referring a child/children for these breaks please find our seperate Referral Form and Consent and Medical From below. 

2017 Help for Heroes Break Referral Form 

2017 Help for Heroes Consent and Medical Form

Group Bookings

If you would like to discuss booking a group of children, then please get in touch with the team using the contact details below. 

Any more questions?

Please check our FAQs in the first instance. If you have any further queries that aren't answered here, please get in touch: or call 01822 811020.

"CHICKS breaks are a source of pure, uncomplicated happiness for a child who has had some difficult experiences."  Referral partner, Hackney