TAUPŌ EVENTS CENTRE HOLIDAY PROGRAMME – SENIOR REGISTRATION FORM
Childs Name:
Age:
D.O.B:
_
School: _________________
Medical History/Cultural needs/Behaviour Problems – Please note even the smallest things:
_
_
__
Please indicate Childs Swimming Ability: Strong / Moderate / Learner / Can’t Swim
HEALTH: In case of emergency I give permission for my child to be given First Aid treatment by the programme staff
or to be taken in an ambulance if necessary – parents will be notified immediately
YES/NO
SUN SMART: I give permission for the staff of the programme to apply NZ approved sun block to my child
YES/NO
PRIVACY ACT: I give permission for my child to be photographed for newspapers and notice board advertisements
YES/NO
MEDICATION: Senior staff of the programme are happy to administer medication to your child. If you require staff to
administer medication please ask for a form giving us permission to do so. Medication must be within the expiry date,
and if prescribed by doctor it must have the correct child’s name on it.
PLEASE NOTE ENROLMENT WILL NOT BE ACCEPTED UNLESS EMERGENCY CONTACT AND
DESIGNATED PICK UP IS COMPLETED
---------------------------------------------------------------------------------------------------------------------------Mother/Guardians Name:
Father/Guardians Name:
___
HME Phone:
_ Email: __________________________________________________________
Address: _________________________________________________________________________________
MOBILE Phone Mum:
MOBILE Phone Dad:
___
WORK Phone Mum:
WORK Phone Dad:
____
*Emergency Name and Number (used if parents cannot be contacted)
*ONE:
____
*TWO:
____
*Designated Pick up people other than parents:
Names of anyone FORBIDDEN to pick up your child:
____
____
____
TAUPŌ EVENTS CENTRE HOLIDAY PROGRAMME BEHAVIOUR CONTRACT:
It is our aim at the Taupō Events Centre Holiday Programme to provide a safe, happy and nurturing environment for
your children to participate in sports, leisure and recreation activities during the holidays. This can only be achieved
with the help of you and your children committing to this behaviour contract for the benefit and enjoyment of
everyone on the holiday programme. Our programme provides and environment that encourages children to treat
others with respect and as they would like to be treated. In order to be respected they need to first respect their
peers, the supervisors as well as their surroundings and the equipment provided for them.
If your child misbehaves they will be given a verbal warning, if this behaviour continues they will be put in time out,
if the behaviour still continues you will then be informed and we would appreciate if you could discuss with your child
and enforce the programme rules.
Extreme behaviour: If your child hits another child or emotionally abuses another child they will be spoken to about
this behaviour. If this sort of behaviour continues your child will be instantly dismissed from the programme and you
will be called and asked to come and pick your child up and no refund will given.
The following types of behaviour are not acceptable:
* Swearing * Physical/Verbal Violence/abuse *Stealing * Smoking * Running Away
* Deliberate damage of other peoples belongings.
We expect all children on the Holiday Programme to adhere to the following rules:
* No Physical Fighting
* Respect others property
* Ask to go to the toilet
* No Swearing
* Respect each other
* Try and take part in all activities
* Listen to staff
* Stay inside set boundaries
* Look after Equipment
* Respect Staff
How did you hear about the Taupō Event Centre Holiday Program? ___________________________________
We
and
agree to abide by the Taupō Events Centre behaviour contract
(Parents/Guardians name) (Childs Name)
and understand the consequences should this not be followed:
Signed:
Date:
_
WEEK ONE: MONDAY 29th September-Friday 3rd October 2014
9-13 YEARS SENIOR PROGRAMME
th
Movies, Sport and Library visit -$32
th
Action World- $45
Monday 29 September
Tuesday 30 September
st
Wednesday 1 October
Climbing wall and swimming- $32
Thursday 2nd October
Biking and sausage sizzle - $32
rd
Friday 3 October
KiwiSport -$32
FULL WEEK
$160
WEEK TWO: MONDAY 6th October- FRIDAY 10TH October 2014
9-13 YEARS SENIOR PROGRAMME
th
Sing Star and Gymnastics -$32
th
Mystery Trip- $45
Monday 6 October
Tuesday 7 October
th
Wednesday 8 October
th
Thursday 9 October
th
Climbing wall and Hawaiian Spring Carnival- $32
Orienteering- $32
Friday 10 October
Movies and Spa Park Challenge- $32
FULL WEEK
$160
TOTAL DUE
_______________________
* Please note that the above programme is subject to change.
All enrolment forms are to dropped off with payment/completed WINZ forms at the Taupo Events
Centre/AC Baths Reception.
No enrolments accepted via email
Are you eligible for Work and income funding? We are an approved CYF programme so if you are eligible
you may receive subsidies from WINZ. Find out at your local Work and Income Office.
Children must be provided with the following daily:
 Sufficient food and a water bottle
 Suitable footwear for the days activity
 Warm clothing, rain jacket
TRIP DAY!!! – Please ensure your child/children are signed in by 9am, we cannot wait for late arrivals.