Referral Form

The Changing Lives project provides after school Sports, Dance and social care for primary and secondary school children in Harlow, located within Markhall Academy.
If you are a parent, carer, organisation you can use this referral form. Please make sure to include as much information as possible. 

We provide a School to School Mini-Bus Collection and Drop off service upon request


Please complete the form below

Parents/Organisation Name *
Parents/Organisation Name
Child's Gender
Pick Up Service *
e.g parent will be collecting
Accept terms and conditions (view on website) *
Agree to pictures and videos being taken for promotional material *