SUMMER Holiday Program

SUMMER Holiday Program

Thank you for registering your child to attend the Wildly Curious Holiday Program, your child must be 4.5 years old to participate. Age range is 4 - 12. This program will be held at Charlie's Gelato in the Bamboo Grove. Please complete the form below. Sessions are from 9am - 3pm. Cost is $85. Payment must be paid in full before your child can participate. An invoice will be emailed once you have registered. Further information on our website www.wildlycurious.nz
Child's Name*

First NameLast Name
Child's date of birth*

DayMonthYear
Date
Age your child is*
Parent's Name*

First NameLast Name
Parent's Email*
example@example.com
Current Address*
Parent's Mobile Number*

Area CodePhone Number
Emergency Contact Name (if the parent above is not available)*

First NameLast Name
Emergency Contact Number *

Area CodePhone Number
Relationship to the child*
Please tick the day/s you wish to book*

Tuesday 20th January 9.00am - 3pmWednesday 21st January 9.00am - 3pmThursday 22nd January 9.00am - 3pmTuesday 27th January 9.00am - 3pmWednesday 28th January 9.00am - 3pmThursday 29th January 9.00am - 3pm
Do you have any concerns about your child at this time; social, behavioural, learning? Please be honest in your answer.
Please state if your child has any medical conditions / allergies (including food / animals) or any other information that you feel we should be aware of:
Disclaimer: By enrolling my child in the Wildly Curious holiday program, I acknowledge that outdoor activities involve inherent risks, including but not limited to minor injuries, exposure to natural elements and interactions with animals. I understand that the Wildly Curious team takes all reasonable precautions to ensure a safe and enriching experience. I agree to not hold Wildly Curious or its staff liable for any accidental injuries or incidents that may occur during the program.*

I agree
Signature*

Clear
Address is: Charlie's Gelato, Sharp Road, Matakana.

We will be based in a bell tent for this holiday program. Many thanks, Wildly Curious
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