Requesting a place on a Carer Break

Please let us know the following details if you’d like to request a place on the upcoming Carer Break. Please only do so if you fully intend to come along and are confident you can get caring cover, though we do understand the unpredictable nature of caring duties.

Filling in the form will put in your request – we will then be in touch 4-6 weeks before the break to confirm that you have a place on the break, and finalise any dietary requirements or accessibility needs, and send you more information. Priority will be given to those who haven’t been on a break before or been recently.

If you can’t fill out the form, please leave a message for the carers team at: 07592 202018


We will be leaving at 3pm Friday, and returning around 4:30pm on Sunday.

Note: Please consider these dates are at the start of Easter school holidays, and during Ramadan. Apologies if this is inconvenient for anyone. There will be more breaks and days away organised in the future.

Full Name
Phone Number
Postcode (you must live in a Birmingham City Council area to be eligible for a break)
Are you currently in a caring role?

Are you registered with the Birmingham Carers Hub?

What benefit would you get from attending a break?
Who will cover your caring role while you’re away and have you asked them yet?
Please enter the name and contact number for your emergency contact (we will need this during the break but will not contact them unless it’s necessary while we are there)
Tick this box if you would like to receive future publicity about future breaks

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