Holiday Programme January 2025 Registration Form

PACT Holiday Programme runs one week of every school holidays and before the school year begins in the summer holidays for children aged 7-13

The programme is held in the PACT building, 311 Great South Road, Papatoetoe

The programme runs from 8:45am—3pm (additional hours available on request).

There is a cost of $20 per non trip day and $35 per trip and special activity for each child.

You can enrol your children for whichever days you choose.

Parent / Caregiver Contract:

I / we agree and acknowledge:

I have read and understand the Information for Parents / Caregivers. The PACT Holiday Programme has been approved under the MSD OSCAR Standards.
All care will be taken to provide a safe and well-supervised
environment for children attending the programme, in accordance with our Holiday Programme policies and procedures.
The PACT Holiday Programme Policies and Procedures can be viewed here.
The Holiday Programme Co-ordinator has my permission to arrange urgent medical treatment, at my cost, and to move my child by private motor vehicle or by ambulance, if necessary.
I will notify the Holiday Programme Co-ordinator of any changes to enrolment information in a timely way.
I understand that PACT is a Christian organisation and that there will be Christian devotions, prayers and open discussions about Christian faith during the Holiday Programme.
I agree to pay fees as stipulated in the fees policy.
I give permission for my child to take part in the trips over the week and to be transported to and from these trips. *A timetable with the specific trips will be made available before the first day of the programme. Please let us know if you have any concerns.
I understand that the programme management reserves the right to exclude from the programme any child who is frequently disruptive, ignoring programme rules, or who poses a significant risk to the safety of themselves or others. The programme strives to be fair, positive and consistent in helping children behave appropriately.
I understand that if my child is sick or doesn't attend Holiday Programme after I've made the booking that the fees are still payable.
I understand that if a Holiday Programme staff member witnesses or suspects neglect or abuse of any young person, they are required to inform the appropriate authorities.

Please tick if you DO NOT want your child photographed. Photos may be used on our website, Facebook page, Instagram or other PACT publications.

We would like to include your email address in our PACT database so that we can send you our newsletter and other information from time to time. Please indicate below if you give permission for your name and email address to be added.

Yes I give permission

Please sign this contract to complete enrolment form.

Privacy Act 2020: The information that you have supplied is necessary for the safe and effective operation of the holiday programme, and has only been collected for that purpose.
You may review information pertaining to your child’s enrolment at any time.

Fees: The cost is $20 per child for non trip days and $35 for trip days. Once we receive your completed enrolment form we will send you an invoice for the fees a deposit of $50 must be paid by 10 January 2025 to confirm their place in the programme and full fees are due by 17 January 2025

Assistance with fees is available so please let us know if you require a discount.

WINZ subsidies are also available, but please let us know first if you intend to apply.

Internet banking: 12-3044-0377903-00 ref: child’s name and/or invoice number PLEASE NOTE the new bank account details (00 rather than 09).

Cancellations: No refunds of fees will be given after 17 January unless we can fill your child's space.

Day register: Parents/caregivers are required to sign their children in and out of the programme. Children may be signed in no earlier than 8.45am, and must be picked up no later than 3.15pm. If your older child is coming to or from the programme without a caregiver please write a note confirming your permission for this arrangement.

Additional hours: You are able to sign your child up from 8am-5pm, an extra $5 per extra hour (outside of 8.45am-3pm) will be charged per child.

Written notification: Written notification is required if someone other than the parent/caregiver is collecting your child/ren. No child is to leave the programme unaccompanied without permission from the parent/caregiver and prior agreement by the Holiday Programme Co-ordinator.

Emergency contacts: Please provide at least 1, preferably 2, emergency contacts who are not a parent.

Sick children: Please contact PACT and leave a message (before 9.30am) if your child is unable to attend the programme for that day. Children who are unwell should not attend the programme. If your child becomes unwell or is injured while on the programme, parents/caregivers or emergency contacts will be notified.

Appropriate clothing: Appropriate clothing should be worn, as we cannot be responsible for spoiled or lost property. Please name children's belongings. We will endeavour to return named lost property. Please make sure that your child has a hat and has applied sunscreen. Each day please pack a change of clothes.Pack a towel and togs every day for the January holiday programme.

Morning tea is provided each day except on the day of the Parakai Hot Pools trip. Please note that your child will need to bring a bag with a packed lunch each day.

Any queries please contact us on hp@pact.org.nz

Please indicate the days/sessions that you are enrolling them for (please note some children may go on the trip on the Thursday so if you want your child/ren to go on a particular day please let us know)*

Monday 20 January 8.45am - 3.00pm $20Tuesday 21 January 8.45am - 3.00pm $20Wednesday 22 January 8.45am - 3.00pm $35 (trip day to Wero Whitewater Rafting)Thursday 23 January 8.45am - 3.00pm $20Friday 24 January 8.45am - 3.00pm $35 (Parakai trip day)

If you require extended hours please write the days and the extra hours needed below. Please note extended hours will be charged at $5 per hour per child.

WINZ subsidies are available for families with one child earning up to $103,480, for two children $127,399 and for three children up to $143,312. For more information and to apply please visit the Work and Income website and let us know if you are applying. Subsidies range from $11.40 to $30+ per day.

Yes I am going to apply for a WINZ subsidy

Child(ren)'s Details

How many children are you enrolling?*

One childTwo childrenThree children

Child 1*

First NameLast Name

EthnicityDate of Birth

Gender

Child 2

First NameLast Name

Gender

EthnicityDate of Birth

Child 3

First NameLast Name

EthnicityDate of Birth

Gender

People authorised to collect your children*

Mother/caregiver one details*

First NameLast Name

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Email*

example@example.com

Mobile number*

Area CodePhone Number

Father/caregivers two details

First NameLast Name

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Email

example@example.com

Phone Number

Please enter a valid phone number.

Emergency contact details*

First NameLast Name

Relationship to child*

Mobile Number*

Area CodePhone Number

Emergency contact details (second person)

First NameLast Name

Relationship to child

Phone Number

Area CodePhone Number

Additional Information

Does your child have any particular health needs we should be aware of? Eg, allergies, food requirements, asthma, medical conditions etc. Please list any medications taken or required:*

Is there anything else we should know about in order to take good care of your child? Eg, custody arrangements, special needs (including cultural), behavioural needs etc.

There are water activities included in the programme. Children will be supervised at all times. Can you please comment on your children/s confidence in the water?

PACT Holiday Programme Enrolment Form

Parent / Caregiver Information

Enrolment Form

Child(ren)'s Details