Squiggle Re-Enrolment Form: 17th - 21st Dec 2018 & 7th - 25th Jan 2019
If you've already enrolled your child/ren into Squiggle, you can use this re-enrolment form instead of completing the usual enrolment form.

Please note that our daily costs are $43/day. If you have more than one child, you will receive a 20% discount. Families who are eligible for WINZ will not be eligible for the discount. There are additional costs for offsite trips.

We will be open during the 17th - 21st Dec 2018 and 7th - 25th Jan 2019.

We will be operating from Waikato Diocesan School (Fairfield).

Offsite activities over the Christmas holidays will include additional costs for entry fees and transport:

Fri 21st Dec - Movies additional $15.00
​Fri 11th Jan - Zoo additional $15.00
Fri 18th Jan - Hamilton Gardens additional $5.00
Fri 25th Jan - Movies additional $15.00

Once you have completed the form, we will send your invoice for payment which must be paid prior to your child attending the programme.

If you are eligible for WINZ/Study Link, please ensure you have approval with WINZ/Study Link prior to enrolling your child/children. You are required to make a 50% deposit before you enrolment can be completed.

Please ensure you have read and agreed to the Disclaimer for enrolling your child/children (www.squiggle.org.nz/disclaimer).

Child's Details
Please complete the following information for your child/ren.
Child 1 - First Name *
Your answer
Child 1 - Surname *
Your answer
Child 2 - First Name
Your answer
Child 2 - Surname
Your answer
Child 3 - First Name
Your answer
Child 3 - Surname
Your answer
Emergency Contact Details
If there are any changes to your emergency details, please add here. If there are no changes, leave blank.
1st Emergency Contact Full Name
Your answer
Relationship to child
1st Emergency Contact Mobile/Phone
Your answer
2nd Emergency Contact Full Name
Your answer
Relationship with child
2nd Emergency Contact Mobile/Phone
Your answer
Health and Special Needs
If there are any changes to their health and/or medical conditions, please list these. If there are no changes, leave this section blank.
Health and/or medical conditions
Please advise what treatment is required OR what allergies your child has and any medication they are required to take. It may also be helpful to tell us why they need medication.
Your answer
Special needs
Does your child have any special needs, e.g. physical, social, cultural, emotional. To help us take good care of your child/ren, please fill in as much detail as you think we need to know (so there are no surprises).
Your answer
Un-Authorised Collection
If there are changes to who CANNOT pick up your child/ren, please fill in this section.
Full name of UNAUTHORISED person
Please advise who IS NOT authorised to collect your child
Your answer
Relationship to child
Dates and Location
Choose which dates and location you'd like to enrol into.
Choose how many days your child will be attending the HOLIDAY PROGRAMME. *
Choose full week option or daily option
Required
Parent/Guardian Details
First Name of Parent/Guardian *
Your answer
Surame of Parent/Guardian *
Your answer
Email *
Your answer
Relationship to child *
Mobile/Phone *
Your answer
Are you applying for WINZ/Study Link subsidies?
If you are eligible for WINZ, please ensure receive approval prior to the programme commencing. A 50% deposit will be required before your enrolment can be completed.
Will your child/ren be arriving/departing unaccompanied (only for children over 10 years old)
If yes, please advise how they will be arriving, e.g. bus, bike, walking and expected time of arrival and departure
Your answer
Terms and Conditions *
To complete your child's enrolment, you must agree to the programme Disclaimer
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This form was created inside of TriMaori Charitable Trust.