Easter Holiday Program

Easter Holiday Program

Thank you for registering your child to attend the Wildly Curious Holiday Program, your child must be 4 years old to participate. Age range is 4 - 11. This program will be held at The Farmer’s Daughter in Omaha. Please complete the form below. Sessions are from 9am - 12.30pm. Cost is $50. Payment must be paid in full before your child can participate. 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 15th April 9.00am - 12.30pmWednesday 16th April 9.00am - 12.30pmTuesday 22nd April 9.00am - 12.30pmWednesday 23rd April 9.00am - 12.30pm
Do you have any concerns about your child at this time; social, behavioural, learning? Please be honest in your answer. If your child needs one on one assistance you will need to either accompany them or provide support for them.
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:The Farmer's Daughter, 329 Omaha Flats road, Omaha.

We will be based in a bell tent on the lawn area for this holiday program. Please include a yoga mat in your child's gear needed.

Many thanks, Wildly Curious
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