"Limestone Rangers" - Sign up Form (Summer Holidays 2021)
Please complete this form if you want to book your child(ren) in for the Limestone Rangers School Holiday programme (Summer Holidays 2021). Price is $55 per child / day.

Note - Please fill in this form even if you have booked with us in the past. However, once you have done this, If you would like to amend your booking or book additional days during the Summer Holidays, please just email safeoutdoorsnz@gmail.com with the additional dates and I will simply transfer your information (no need to fill this form again).

FYI: We are also running the "Nature'sCool" Holiday Programme in Huanui during these holiday. Here's the link if you wish to book: https://forms.gle/qecEB9Cq7UzJSBis5 ($50 per child / day).


Thank so much for your support! Luke, Hilary, Emma & Claire
Email address *
Parent name *
Parents contact phone number *
Alternative Emergency contact number (different than above) *
How many children are you signing up? *
What is your child / children's full name(s) and how old are they? *
What date(s) are you wanting to book in ?
Wed 6th Jan
Wed 13th Jan
Wed 20th Jan
Wed 27th Jan
Row 1
Pick up time & after hours supervision request: Please select the pick up option which applies to you and add the corresponding amount to your total payment in the question below:
3pm - 3.30pm (no extra charge)
3.30 - 3.45pm (+ $6.50) per person
3.45 - 4pm (+ $13) per person
Onerahi Playground
Does your child have any medical conditions we should know about? - (please include for each child: symptoms, treatment and emergency response if necessary) *
Does your child have any behavioral or learning characteristics that we should know about? (please include a description for each child if necessary). *
Does your child have any food allergies we should know about? (please include a description for each child if necessary) *
In the event of an incident / accident or emergency, do you give Safe Outdoors NZ staff permission to administer "over the counter" medication - including paracetamol, antihistamines or Ventolin (blue inhaler) to your child(ren)? *
If your child is under 6 years of age then they must be accompanied by a (full paying) older sibling or close friend who is 7 years or older- please detail below
Media Release: please let us know if you / your child(ren) are comfortable with photos / videos of your child(ren) being used on our social media site(s) and / or our website? *
Authorisation: By ticking "Agree" below, you as a guardian of the child or children (listed above), agree to the terms and conditions as outlined on the website: https://safeoutdoors.co.nz/limestone-rangers *
Required
Please write below a brief summary of what you are paying for e.g: (1x child / single day = $55) or (1 x child / 2 x days + $13 late pick up both days = $136) *
Payment: To confirm your child(ren)'s place in the programme - please make a Direct bank transfer to ANZ account: "Safe Outdoors NZ Ltd" - 01-0877-0763805-00. Please put the code "LR" followed by your child's last name in the reference. *
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