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  • Registration Form

    Registration Form

  • Please note Children and Young People should only be referred to either Out and About or Holiday Short Breaks. Referrals should NOT be made to both services.

    • Child or Young Person Basic Information 
    • Child or Young Person

      Child or Young Person

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    • Parent/Carer Basic Information 
    • Parent or Carer

      Parent or Carer

    • Emergency Contact Information 
    • Emergency Contact Information

      Emergency Contact Information

      This should be a different contact to the parent/carer contact information added above
    • Permissions and Consent 
    • Permissions and Consent

      Permissions and Consent

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    • Disability Information  
    • Disability Information

      Disability Information

    • Please provide further details with regards to your child's needs below.

      The more information you provide the better we will be able to identify appropriate support for your child.
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    • Medical Information 
    • Medical Information

      Medical Information

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    • Befriending 
    • Befriending

      Befriending

      The befriending service is delivered by volunteers who meet with Children or Young People on a 1:1 basis.

    • WHO IS THE BEFRIENDING SERVICE APPROPRIATE FOR?  THE SERVICE IS SUITABLE FOR DISABLED CHILDREN AND YOUNG PEOPLE WHO:

      • Are aged 5 to 18 years old
      • Can form an ongoing befriending relationship with a volunteer.
      • Have behaviour which allows a volunteer to look after them safely 1:1. 
      • Need or would benefit from 1:1 support to achieve more independence from their primary carers and take part in social and leisure activities
      • Have a parent or carer who would benefit from a short break.
      • Would ideally like a volunteer for between 2-4 hours a week on a regular basis.

      THE BEFRIENDERS ARE UNABLE TO:

      Help with intimate personal care or frequent help with lifting and moving. If in the home parent/carer can. 

      • Help with medication or medical procedures from their volunteer.
      • Have a home situation which would cause their volunteer to be unsafe when visiting (i.e. hygiene and basic safety standards within the home, risk to injury within the home etc.).
      • Need a volunteer to stay after midnight.
      • Are in crisis.

      We are not able to place a volunteer with a child who has unpredictable or unmanageable behaviour which could place them self and others at risk.

      There is no guarantee a suitable volunteer will be found and placed.

       

    • Volunteer Requirements

      To make sure we can try to source a volunteer who meets the needs of your family please let us know what you would require from a volunteer.
    • Assessing Vulnerability and Prioritising Need Process  
    • Assessing Vulnerability and Prioritising Need Process

      Assessing Vulnerability and Prioritising Need Process

      We collect this information in order to help us prioritise children and young people who need the service the most
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