Inspire to Change - Referral Form

Before you start

Inspire to Change is an 8-week project aimed at young people who are at risk of offending or re-offending. We will be offering Boxing, Weightlifting, Multisport games, and Assault course activities, with Mentors present at each session. We will be offering 2 sessions in Dover and 2 sessions in Deal each week. After successfully completing the programme, the participants will then be offered the opportunity to undertake further activities within our Inspire Programme.

The Inspire to Change programme will be open to those aged between 10 – 18 years old (25 years old if a SEN is identified)

On completion of this Referral Form, there is a requirement for the Referrer to read through the Disclaimer at the end with the Young Person and Parent/Guardian. The Disclaimer is an agreement by both the Young Person and Parent/Guardian to acknowledge that if the young person continues or becomes involved in criminal activity, they may be removed from the project and if any information regarding criminal activity is disclosed it may be passed onto a third party and the Parent/Guardian will be informed.

During this form, we will ask you for the following:

  • The referral partner details
  • The young person’s details
  • The parent/guardians details
  • To consent to a disclaimer
  • The reason for your referral

Please ensure you have discussed with the parents/guardians prior to completing the referral and they are happy for you to continue.

Using this form

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Privacy Statement

Dover District Council is a Data Controller under GDPR. In submitting this form we will collect and process your personal data. For information about your rights and how the Council uses your data, please view our Corporate and relevant service privacy notice which can be found on our Privacy Page.