Dec 2023/Jan 2024 Johnsonville (New) Holiday Programme

Student's Full Name:*

First NameLast Name

MaleFemale

Student's Birthday*

Date

Student's School:*

Parent / Caregiver Full Name:*

First NameLast Name

Parent / Caregiver Phone Number*

Area CodePhone Number

Parent / Caregiver Email Address*

example@example.com

The following adult is authorised to pick up my child:*

First NameLast Name

Please select the programmes you wish to enrol in:*

Early Explorers - Monday 18th Dec, 2023

Monday, 18th December 2023 (9:00am - 4:00pm)

$69.00NZD

Tales of the Tombs - Tuesday 19th Dec, 2023

Tuesday, 19th Dec 2023 (9:00am - 4:00pm)

$69.00NZD

Technological Time Warp - Wednesday 20th Dec, 2023

Wednesday, 20th Dec 2023 (9:00am - 4:00pm)

$69.00NZD

Extra-terrestrial Odyssey - Thursday 21st Dec, 2023

Thursday, 21st Dec 2023 (9:00am - 4:00pm)

$69.00NZD

Friday 22nd Dec , 2023 Not Available

$ FreeNZD

Avengers Ascent - Monday 15th Jan, 2024

Monday, 15th Jan 2024 (9:00am - 4:00pm)

$69.00NZD

Comic Crusaders - Tuesday 16th Jan, 2024

Tuesday, 16th Jan 2024 (9:00am - 4:00pm)

$69.00NZD

Teenage Turtle Takeover - Wednesday 17th Jan, 2024

Wednesday, 17th Jan 2024 (9:00am - 4:00pm)

$69.00NZD

Guardians and Galaxies - Thursday 18th Jan, 2024

Thursday, 18th Jan 2024 (9:00am - 4:00pm)

$69.00NZD

Friday 19th Jan, 2024 Not Available

$ FreeNZD

Monday 22nd January 2024 - Public Holiday

$ FreeNZD

Fun Fair Fiesta - Tuesday 23rd Jan, 2024

Tuesday, 23rd Jan 2024 (9:00am - 4:00pm)

$69.00NZD

Summer Showdown - Wednesday 24th Jan, 2024

Wednesday, 24th January 2024 (9:00am - 4:00pm)

$69.00NZD

Island Escape - Thursday 25th Jan, 2024

Thursday, 25th January 2024 (9:00am - 4:00pm)

$69.00NZD

Friday 26th Jan, 2024 Not available

$ FreeNZD

Total

$0.00NZD

Credit Card Details
First Name	Last Name
Credit Card Number	Security Code
Card Expiration

Special Instructions

I agree not to send my child to a Bricks 4 Kidz Holiday Programme if presenting with cold or influenza-like symptoms.

I agree to my child receiving minor medical treatment, as considered necessary by first-aid certified staff. Furthermore, I agree to staff seeking further medical attention in the event of an emergency and I consent to treatment by medical authorities present.

YesNo

Johnsonville Dec 2023/Jan 2024