Kamo Kidzone Holiday Programme Enrolment Form

Children

Child Name 1 *

Child 1 Age *

Children2

Child Name 2

Child 2 Age

Children3

Child Name 3

Child 3 Age

Children4

Child Name 4

Child 4 Age

Email *

Home Address

Postcode

Contacts

People authorised to collect your child/ren

Parent/Caregiver 1

Caregiver 1 Phone

Parent/Caregiver 2

Caregiver 2 Phone

After Hours Phone

Emergency Contacts

Doctor

I give permission to administer first aid and to seek emergency treatment if necessary.

Click here>> to read the Kidzone Contract

I have read and agree to the Kidzone contract *

Yes

Is there anything else we should know about in order to take good care of your child/ren?

PRIVACY ACT 1993: The information that you have provided is necessary for the safe and effective operation of the programme and will be used for the sole purpose of emergencies, birthdays and health and safety of the children as set out in the Policies and Procedures.

Permissions

perm1

I give permission for my child to participate in all organized trips as advertised in the programme itinerary. I have received all the relevant information.

I give permission for my child to participate in unadvertised, low-risk walks away from the school in the local environment eg. Parks and Shops.

I give permission for my child to swim in the School pool whilst supervised by Kidzone staff.

I give permission for the supervisor to arrange urgent medical treatment for my child at my cost.

Photographs of my child/ren may be used for genuine publicity purposes of this programme. They may include hard copy and internet.

I give permission for Kidzone staff to sign my child in/out of the programme. I will notify them by 9.30 if they are not attending.

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