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Acceler8 14-18 year olds
Illumin8 18–30 year olds
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If you or someone you know would like to become a member of Actvie8 please complete the form below and we will be in touch
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The person you are referring
Email address (parents/carers)
Mobile number (parents/carers)
Full name *
Organisation/Relationship to Referee
Information about the person you are referring
School/college/university name, address, contact at school/college/university (e.g. SENCO/Tutor), course interests.
Have you discussed Active8 with the young person?
Have you discussed Active8 with the parents/carers?
Tell us about the young person
Personality, needs, interests; what is this young person like?
Does s/he have a physical impairment?
If so, roughly what is it and how does it affect him/ her?
Does he /she use a wheelchair?
Electric/ independent manual/ passenger? Need one for any distance outdoors? Need to travel in wheelchair? (If they don’t have what they need to be as active as possible, please start the ball rolling now – we know how long it takes!)
Does he/she have a learning disability?
If so, do you have any idea of IQ or ability level? We are unable to cater for people with significant learning disability as we are set up to work with young people with physical disabilities, however we may be able to sign post to other organisations working with people with learning disabilities.
Any other health problems?
Any major social problems?
Any comments on level of co-operation/ commitment?
Young person and/or parents. Do you think they might get there regularly, and more or less with the right kit?
Anything else you’d like to tell us…
Would you like to receive our newsletter which includes updates about the charity and information about fundraising and day events for all the family?
Please indicate the ways in which you are happy for us to contact you :
We will not share your information.
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