Short Family Break Application                                         

If you have a long term sick or disabled child (any long term illness or disability will be considered for support), we are able to offer your family a short break at our holiday home at Butlins in Skegness*. This will be on a self-catering basis and there is no hire charge, but the holiday will be subject to a £100 security bond which will be returned at the end of your holiday. 

Breaks are available from March - July and September-November and are either weekend (Friday - Monday) or mid-week (Monday-Friday).

*Holidays are subject to acceptance and availability, so please do not book any holiday from work or school until the break dates are confirmed to you in writing.

Applicant Details

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About The Child

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Child's Current Status
Does the child receive DLA/PIP
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Payment Details

Holiday Details

The maximum number of people that are allowed in the holiday home is six (6), over-occupancy will not be allowed. The free holiday will be subject to a £100 returnable bond (on acceptance) and is subject to the holiday terms and conditions which will be sent with your booking. Dates are subject to availability and support acceptance.
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Please provide details of all guests for the caravan, along with their relationship to the disabled child and their date of birth.
Do you need a disabled access caravan?
<<< Enter the name of the disabled child here.

Acceptance Declaration

This is my application for support in the form of a free holiday from Yorkshire Children’s Trust. I can confirm that the information I have provided is correct and understand that providing incorrect or misleading information will result in the application being withdrawn and all future applications automatically declined.

Both the professional making the application and the named parent or legal guardian explicitly agree to the charity using the supplied information in line with GDPR regulations, to store and use the data in connection with the verification and processing to successfully provide the services of the charity.

Both the applicant and the named parent or legal guardian also agree to members or agents of the charity to contact outside agencies and for them to release sensitive data which will include names, dates of birth, medical conditions and illness details and hospital stays, this is only for the reason of decision making in relation to this support application.

Free Holiday Application V2 (July 2020)

Yorkshire Children's Trust

Registered Charity Number 1146884

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Telephone 01422 72 80 80

YCT House  70 Commercial Street  Halifax • HX1 2JE

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