Section 2 – Referring Coach / Club Representative
Section 3 – Child / Young Person Details
Section 4 – Reason for Referral
Please outline why the child is being referred for support (tick all that apply):*
Section 5 – Participation & Engagement
Section 6 – Safeguarding Confirmation
By submitting this referral, the club confirms:*
Section 7 – Funding Understanding
By completing this form, you confirm that:*
Section 8 – Declaration
I confirm that the information provided is accurate and that the referral is made in the best interests of the child.
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What Happens Next
Village United CIC will:
• Review the referral
• Contact the parent/carer for confirmation
• Assess eligibility and availability
• Confirm funding arrangements where approved
Response timeframe: 10–14 working days
