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.