Respite Breaks

Holiday Confirmation Form

Congratulations! Your support application for a respite break has been accepted and we now need to collect some information on your family so we can book the break for you.

Please remember this break is provided on a self-catering basis in one of our caravans and we do not include any entertainment passes in our respite breaks, but are pleased to provide a list of great locations to visit with your family on our main respite break page.

Application T&C: Click here / Butlins T&C: Click here

Holiday Confirmation Form

Please complete all relevant questions on this form


We need to know if you need an accessible (wheelchair friendly) caravan. Unless you specifically need a wheelchair accessible unit you may be booked into either holiday home.

Sandhills 246
Our accessible caravan has wheelchair ramped access, wide doors and a full wet room. The master bedroom boasts a kingsize bed with Otty mattress and basic hoist. The twin bedroom has two full size single beds and a small double pull-out is in the lounge area. Maximum of 6 guests.

Sandhills 261
Our second caravan is three bedrooms and include a bedroom with a double bed, two twin rooms and a small double pull-out in the lounge. Maximum of 8 guests. Please be aware, this caravan is not suitable for wheelchair users, or those with additional mobility needs.

Booking Dates
Our respite breaks are to be provided at the earliest opportunity to help aid positive mental health of your entire family.  You will be given either a Mid-Week or Long-Weekend break, but this will be subject to availability, most breaks are mid-week.

Mid-Week Breaks are Monday to Friday
Weekend Breaks are Friday to Monday

Your break will most likely be

Guest Details
As per the Butlins terms and conditions, we need to take the full names and dates of births of all guests to provide your holiday. Butlins handle the checking-in/out of our guests.

Important: Please remember we can only provide this free respite break to your immediate family who reside in your household. Adding friends or extended family members may lead to the offer of a break being withdrawn.

Please enter the first and last name of each guest below, including their title prefix.


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Second Guest

Third Guest

Fourth Guest

Fifth Guest

Sixth Guest

Seventh Guest

Eighth Guest

Please use your finger or mouse to sign this document.