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 are welcome back each year (depending on the previous break report and suitability) but they may only attend once per calendar year. 

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

Please Note: we have very limited availability for the remainder of our 2017 breaks and no longer have any KS4 spaces this year. Our 2018 referral form will be on our website soon. If you still wish to send in a 2017 referral:

View our break dates

Complete a 2017 Break Referral Form

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

Please note, submitting a referral does not guarantee a place on one of our breaks. We will be in touch with you as and when a space becomes available for your referral(s). 

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