ZEALANDIA HOLIDAY PROGRAMME – REGISTRATION FORM
IMPORTANT: Your booking is NOT confirmed until we receive the following information.
Name(s) of attendee(s)
School attended
Age(s) of child/ren:
Do your children require special considerations?
Health (including allergies and other medical
requirements)
Behaviour
I agree to the use of photographic images of my child/ren on
ZEALANDIA’s website or Facebook /Education pages
YES
NO (please circle)
What time do you expect to drop off and pick up your children on the following dates?
Date
8am-9am drop off
Mon 5th October
Tues 6th October
Wed 7th October
Thurs 8th October
Frid 9th October
Main contact email address:
12.00-12.30 pickup
(if half day option)
3.30-4.30 pickup
(if whole day)
I have read and agree to the Terms and Conditions (attached) and supplied all relevant
information regarding the child(s) health, medication requirements and behaviour:
Please type ‘yes’ to agree:
Name of parent or guardian:
Mobile number:
Date:
Secondary Emergency Contact:
Name:
Relationship to child:
Phone:
Mobile:
TERMS AND CONDITIONS
Zealandia Holiday Programme Days
Monday
5th October 2015
Tuesday
6th October 2015
Wednesday
7th October 2015
Thursday
8th October 2015
Friday
9th October 2015
Times:
 Drop off times are between 8am-9am. Arriving late means missing parts of the programme.
 Pick up times are 12- 12.30pm for a half day option and 3.30-4.30pm for the whole day option. A
penalty fee of $10 per half hour is applicable for late pickups – please be on time!
Refund policy
We do not offer refunds once bookings have been made.
What to bring:
 Morning snack, lunch and water for the day
 Weather appropriate clothing (Waterproof Jacket and trousers + a change of shoes/socks)
 Sturdy footwear such as trainers/trekking shoes – no jandals please
 Any required medication (as noted in earlier fields)
 An adventurous spirit!
Payment:
To make a payment via internet banking please use the following bank details:
WESTPAC
03-1540-0018062-00 Karori Sanctuary Trust
For the reference please use ‘Holiday Programme’ and your child(s) name.
If you have any further questions or concerns, please contact ZEALANDIA’s Education Team, on
Education ph 04 920 9204 or email Education@visitzealandia.com