"Kids Outdoors Huanui" - Sign up Form (Term 2 / July Holidays 2019)
Please fill this form in if you wish your child / children to attend the "Kids Outdoors Huanui" - School Holiday Programme based at Huanui College. Please ensure you have read carefully the Information / Terms & Conditions @ https://safeoutdoors.co.nz/kids-outdoors-huanui before completing this form.
Email address *
Parent name *
Your answer
Parents contact phone number *
Your answer
Alternative Emergency contact number (different than above) *
Your answer
How many children are you signing up? *
What is your child / children's full name(s)? *
Your answer
How old are they? *
Your answer
If your child is under 7 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
Your answer
What date(s) are you wanting to attend in July?
Tues 9th (5 spots left)
Wed 10th (2 spots left)
Thurs 11th
Mon 15th (added due to demand)
Tues 16th (sorry full)
Wed 17th (sorry full)
Thurs 18th (sorry full)
July
Would you be keen for any additional dates? (If we get enough kids keen then we will let you know asap)
Monday 8th
Friday 12th
Monday 15th
Friday 19th
Tues 23rd
Wed 24th
Thurs 25th
July
Does your child have any medical conditions we should know about? - (please include for each child: symptoms, treatment and emergency response if necessary) *
Your answer
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)? *
Does your child have any behavioral or learning characteristics that we should know about? (please include a description for each child if necessary). *
Your answer
Does your child have any food allergies we should know about? (please include a description for each child if necessary)
Your answer
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/kids-outdoors-huanui *
Required
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:
3.30 - 4pm (no extra charge)
4 - 4.15pm (+ $7.50) per person
4.15 - 4.30pm (+ $15 per person)
4.30 - 4.45pm (+$25) per person
Huanui College
Mari Park Playground
Shuttle Van request (+ $5 One way or Return) Mair Park Playground - Huanui College Return.
RETURN ( 8.30 - 8.45am) & (3.45 - 4pm)
ONE WAY (8.30 - 8.45am) ONLY
ONE WAY (3.45 - 4pm) ONLY
Pick up
Please write below a brief summary of what you are paying for e.g: 1x child / single day = $45) or (2 x children / single day + shuttle = $100) or (1 x child / 2 x days + $15 late pick up Huanui both days = $120) *
Your answer
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 "HUA" followed by your child's last name in the reference. *
Submit
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