Booking Request

Request a booking by completing the form below.

Stays at Logan’s Sunny Days are up to a maximum of 7 days from 2pm Saturday until 10am the following Saturday (we appreciate you may not be able to stay the full 7 days or arrive on the Saturday itself but if you make the booking for the week initially and mention in ‘further information’ about limited stay.

Start Dates requested

First Choice-

Second Choice-

Personal Details

Your Name

Date of Birth

Male/Female
MaleFemale

Illness/Diagnoses

Family

Parent/s (or Guardian's) name/s

Home address & Postcode

Preferred contact number/s

Child's siblings/ages

Third party referral

3rd party referral - This section is only to be completed if you aren’t the child’s parent or guardian. We will gladly accept referrals from out with the immediate family (e.g. other family member, friends, other charity, professional representative etc.). Please complete this section if this applies to this referral. Please note we will always contact you in first instance before contacting the child’s parents/guardians.

Your Name

Relationship to family

Contact Number

Your Email

Is the family aware of this referral?
YesNo

Social Worker Details

Name

Contact number

Where based

Who is coming?

(up to a maximum of 6 persons. Please let us know of any changes nearer the time). Please advise us for each person coming their name, relationship to child, Interests/hobbies and whether they are male or female

First Person

Second Person

Third Person

Fourth Person

Fifth Person

Sixth Person

Any special requirements during stay? (e.g. high chair, travel cot etc.)

Medical Journey -It is helpful to us to have an overview of the story so far, treatment undertaken to date, current situation and proposed treatment.

Further information - Anything further you would like to tell us about your child, your family, circumstances.

Publicity - Would you allow us to publicise any award we make on our website/social media pages?
YesNo

We will always respect your wishes and level of privacy. There may be certain occasions where we think certain grants may be worthy of a press release – again we will always discuss the possibilities of this before we take any action.

Important: While treatment is still on-going you will need to seek medical release permission from your child’s consultant/doctor. It is also important that you bring with you details of your child’s medical situation including medication and allergies. It is strongly suggested you do the same for any of the other guest who may have health issues.

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