Holiday Program

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 4.5 - 12. This program will be held at Brick Bay Vineyard, Snells Beach. Please complete the form below. Sessions are from 10am - 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*
Tuesday 7th April 10.00am - 3pmWednesday 8th April 10.00am - 3pmThursday 9th April 10.00am - 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: Brick Bay Vineyard, Arabella Lane, Snells Beach

We will be based under the sheltered space next to the playground at the Vineyard, please meet there.

Many thanks, Wildly Curious
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