CareFree Breaks Referral Form

CareFree Breaks Referral Form
We have joined Carefree Breaks who offer breaks across the UK for full-time unpaid Carers.

Carers registered with us can join the scheme to book a hotel break which will allow them time out from their caring role. The break is for the Carer and a companion who is not the cared-for person.

The short breaks initiative is designed to provide the flexibility you need to take some time away from your caring responsibilities. Hundreds of hotels nationwide donate to Carefree every day out of their excess capacity, giving you a wide range of choice on the date and location of your ideal getaway.

The cost to a Carer is £38 administation fee.

Click here to find out more about the scheme CareFree and how it works before completing the form.
Yes (please complete this form)No

Name*

First NameLast Name
Date of birth*

DayMonthYear
Date
Phone Number*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email - you will receive an email directly from CareFree to activate your account.*
example@example.com
Name of the Cared for person*

First NameLast Name
The person I care for is my....*
Their DOB is*

DayMonthYear
Date
I understand that by submitting this form I agree…
Yes
Yes
Yes
Yes
Yes
Yes
Once submitted we will send your information to CareFree. You will then receive an email direcly from CareFree confirming your details and a password to activate your account.
Should be Empty: