Kids Domain SEPT/OCT 2025 School Holiday Programme

IMPORTANT INSTRUCTIONS AND INFORMATION:

1. We are a LEVEL 3 ACCREDITED OSCAR PROVIDER - this means we require your full information to be submitted each school holidays even if you are a current After School Fun Club user. If you have more than 1 child, at the end of submitting your booking, choose "book another child in" - all your personal information will already be loaded. Everything with an asterix (*) must be completed or it wont let you submit your booking at the end. If something does not apply to you type or select N/A so you can move to the next question.

2. Choose the centre location you are wanting to book into - the programme schedule will pop up and days that are available.

3. If you are wanting to apply for a WINZ Subsidy but HAVE NOT been receiving a subsidy in the last 10 weeks, an OSCAR subsidy application form will need to be completed by yourself and signed off and processed at our end. There is a cut off date for new subsidy applications (this is 3 weeks before school holidays commence). WINZ form can be downloaded here

4. Cancellation date(s) - changes to your bookings or cancellations. The last date for cancelling Sept October holiday programme dates is Sunday 14 September 2025. Refunds or credits will be not be given after this cut off date. (this also includes any bookings received from this date onwards) This is necessary to ensure that we can effectively roster our incredible staff based on confirmed bookings; any drop in numbers means that we may end up with excess staff, which is not sustainable. Additionally, our activities, venues, and bus charters are prepaid in advance, their staff have been booked to accommodate us and our staff invest considerable time in planning to deliver a successful programme. Additionally, we cannot accommodate swaps for booked days post the cancellation deadline. To cancel you will need to complete the cancellation form https://www.kidsdomain.biz/change-of-bookings-notice-form (A $10 administration fee applies to cancellations and changes to bookings made before the cutoff date). A copy will be emailed to you for your records and a copy will be sent to accounts to action - you will receive an email from us once actioned. Texts, emails or verbal notice is not accepted so please follow the correct process.

5. Need extra days?? If you already have a booking but need extra days and there is availability, you do not need to do another booking - please see the manager onsite or give them a phone call/text and we can manually book you in (please allow 1 working day)

6. Swimming - 5-7 year olds in small pool, 8 years and ups will be allowed in small and big pool and/or hydroslides (if any)

7. Sickness (Protecting Others): If your child is sick, please keep them at home. This helps prevent the spread of illness to other children and staff. We prioritize the health of everyone at our holiday programme. Keeping sick children away ensures a safer environment for all. By following this policy, we create a healthier and happier experience for every family involved. Thank you for understanding

8. Read the terms and conditions carefully before agreeing and signing.

9. Clear your cache and/or internet browser history before you start this form to avoid any issues
STOKES VALLEY HOLIDAY PROGRAMME DAILY FEES:

HALF DAY: 8.30am to 3.30pm....$49.00 (paid within 2 working days of invoice) or $51.00 (* full payment must be received within 2 weeks of invoice due date)

FULL DAY: 7.30am to 5.30pm... $54.00 (paid within 2 working days of invoice) or $56.00 (* full payment must be received within 2 weeks of invoice due date)

TRIPS/VENUES/BUS CHARTERS IS NOTED ON THE ACTIVITY SCHEDULE:............... $19.50

Full payment must be made within 2 working days of invoice to qualify for this discounted rate.

* PAYMENT PLAN TERMS: full payment must be received within 2 weeks of invoice due date
LOWER HUTT HOLIDAY PROGRAMME DAILY FEES:

HALF DAY: 8.30am to 3.30pm....$49.00 (paid within 2 working days of invoice) or $51.00 (* full payment must be received within 2 weeks of invoice due date)

FULL DAY: 7.30am to 5.30pm... $56.00 (paid within 2 working days of invoice) or $58.00 (* full payment must be received within 2 weeks of invoice due date)

TRIPS/VENUES/BUS CHARTERS IS NOTED ON THE ACTIVITY SCHEDULE:............... $19.50

Full payment must be made within 2 working days of invoice to qualify for this discounted rate.

* PAYMENT PLAN TERMS: full payment must be received within 2 weeks of invoice due date
FOUR DIAMONDS HOLIDAY PROGRAMME DAILY FEES:

Please contact Four Diamonds Charitable Trust
YES, I HAVE READ, UNDERSTOOD AND AGREE TO THESE TERMS AND INSTRUCTIONS*

Yes

SEPT OCT 2025 SCHOOL HOLIDAY PROGRAMME
PLEASE CHOOSE ONE*

FOUR DIAMONDSKIDS DOMAIN
Choose a Centre to be Enrolled*
LOWER HUTT - PLEASE CHOOSE YOUR DAYS*
STOKES VALLEY - PLEASE CHOOSE YOUR DAYS*
Because you have selected Tuesday 30 September - please choose the correct location your child will attend (you can only choose 1)*

junglerama (all ages) SOCKS TO BE WORNclip n climb (only 8 years and up) SNEAKERS TO BE WORN OR NO CLIMB
Child*

First NameLast Name
sex of child*

femalemale
Age of child during school holidays*
Address*
Ethnicity Group your child most identifies with (this is collected for statistics purposes)*

MaoriNZ EuropeanEuropeanPacific IslandAsianIndianMiddle EasternAfricanOther
CONFIRMATION OF YOUR BOOKING/INVOICE TO BE EMAILED TO:*

Confirmation Emailexample@example.com
CHILDS HEALTH/MEDICAL (please select all that apply to your child)*

MEDICAL - Asthma, Diabetes etcALLERGIES - Food, insect, medicines etcADHD - attention deficit hyperactivity disorderFASD - Fetal alcohol spectrum disordersASD - Autism spectrum disorderODD - Oppositional Defiant DisorderGAD - Generalized Anxiety DisorderGDA - Global Development Delay/Learning DifficultiesN/AOther
PLEASE READ!!!

If your child can participate in a 1:10 ratio, please continue with this form. If your child requires extra support, all bookings must have a client number through Four Diamonds Charitable Trust and been pre-approved for this holiday programme. If you do not have a client number please click here to fill in the assessment form
Medical Condition: please specify details here (example: what the medical condition is eg has asthma - inhaler in school bag and what the procedure is)*
Allergies: please specify details here (example: allergic to bee stings and what the procedure is)*
ADHD: please specify any details about your child that supervisors need to be made aware of*
ADHD: Does a supervisor need to administer your child's medication?*

YesNo
ADHD: Name of medication required to be administered*
ADHD: Dosage of medication required*
ADHD: Time of day medication is required*
FASD: please specify any details about your child that supervisors need to be made aware of *
ASD: please specify any details about your child that supervisors need to be made aware of *
ODD: please specify any details about your child that supervisors need to be made aware of *
GAD: please specify any details about your child that supervisors need to be made aware of *
GDA: please specify any details about your child that supervisors need to be made aware of *
OTHER DETAILS/REQUIREMENTS*

CUSTODY - Oranga Tamariki, Dept of Courts etc (court documentation will need to be provider if we do not already have them)RELIGIOUS - Social, Cultural or ethnic requirementsLEAVING PROGRAMME - Permission to walk home/parents workplace at the end of programme/my child will walk to the centre and be at the programme by 9am etcN/AOther
Custody: please specify details here (example: in the care of Oranga Tamariki)*
Religious, Social, Ethnic Requirements: please specify details here (example: does not eat pork etc)*
Leaving Programme: please specify details here (example: I give permission for my child to leave the programme at 3.30pm)*
Mother/Caregiver Details*

First NameLast Name
Mother/Caregiver Day Phone*
Mother Workplace/Place of Study*
Father/Caregiver Details*

First NameLast Name
Father/Caregiver Day Phone*
Father Workplace/Place of Study*
AUTHORISED PICK UP PEOPLE: In the event of an emergency and we are unable to get hold of the parent/caregiver, it is very important we have emergency contact people (this could be friends, family, neighbours etc). Please list below:
1st Emergency Contact Full Name*
Relationship to Child*
Best Contact Phone Number(s)*
2nd Emergency Contact Full Name*
Relationship to Child*
Best Contact Phone Number(s)*
OTHER PEOPLE AUTHORISED TO COLLECT YOUR CHILD (Your child will not be allowed to leave if After School Fun Club has not been notified prior to pickup of somebody not listed) *
WHO IS PAYING FOR YOUR CHILDCARE?

PARENT/CAREGIVERICAFSWORK & INCOMEORANGA TAMARIKIBARNARDOSOther
WILL YOU USE PAYMENT PLAN OPTION? (WEEKLY PAYMENTS THROUGHOUT THE SCHOOL HOLIDAY PERIOD WITH THE FULL BALANCE BEING PAID BY FRIDAY 4 JUNE 2025)*

Yes Payment Plan Required (I have read the terms and conditions of payment plan)No I will pay in Full (2 working days of invoice date)
WHEN WAS THE LAST TIME YOU RECEIVED A CHILDCARE OSCAR SUBSIDY?*

I have never applied before - applications must be received by us 4 weeks before holiday programmeI have not received an OSCAR subsidy for over 10 weeks - applications must be received by us 2 weeks before holiday programmeI get an OSCAR subsidy for Before/After School Care currentlyI got a subsidy last school holiday programme
COST: All prices are advertised on our website when booking. An Invoice will be emailed to you to pay on within 2 working days of invoice.

CANCELLATIONS: Refunds/credits will only be given if notice is received before the cut off date(s). Cut off dates are on the website. Please complete this form https://www.kidsdomain.biz/change-of-bookings-notice-form Texts, emails or verbal notice will not be accepted and will not be replied to. A withdrawal fee of $10 will apply per child.

ACCOUNT DETAILS: Kids Domain, ANZ Bank, 06 0545 0282917 00 - please use your child's first/last name as reference/particulars or use the invoice number. All invoices/statements are emailed. Accounts that are not paid on time will incur a $5.00 late payment fee each week outstanding until the account is zero balance. Unpaid fees will be placed with a debt collection agency and/or department of courts where parents/caregivers will be liable for collection & court fees incurred. Payment plans require weekly payments with full cost of holiday programme paid by Monday the last week of school holidays.
WINZ APPLICATIONS: New applicatons need to be received 4 weeks before school holidays start to allow for processing times/delays. Current applicants need to be received by Kids Domain at least 2 weeks prior to school holidays starting. WINZ subsidy forms are available to download from our website https://www.kidsdomain.biz/winz-oscar-subsidy We accept applications scanned/emailed directly to us to make things easier for you as we have a dedicated WINZ co-ordinator. This means you do not have to visit a WINZ office. Please email: kidsdomain@slingshot.co.nz - make sure you have fully completed your form and attached latest payslip if you are working (a photo of payslip is fine as long as it is clear to read) WINZ will decline your subsidy if payslip has not been provided.

LATE PICKUPS: Pickups from 4.30pm (Stokes Valley Centre) and 5.30pm (Lower Hutt Centre) will incur a late pickup fee of $20 for the first 15 minutes and $5 per minute after that. This fee will be applied to your account to cover the cost of staff having to work overtime. If you are only booked in for a shorter session, late pickups will be charged at the full day rate. We book staff on according to the number of session bookings.
OTHER INFORMATION: Parents/caregivers are to see a staff member on arrival so they can sign your child in on the Ipad, upon pickup please see a staff member so they can sign your child out on the Ipad. Please ensure all medication is given to a supervisor so they can administer and record on their file. By giving medication to staff you give consent for them to administer. All medication in pill form has been given in the correct dosage for that day. We cannot cut tablets in half, quarters (this has to be done by the parent/caregiver) for health and safety reasons. Please bring everyday - morning tea, lunch and water bottle. During summer sunhats and sunblock are required everyday. We also request you to sunblock your child prior to attending in the mornings. Outdoor pools/beach trips we highly recommend your child wear a rashvest/t-shirts/hats to protect them from the harsh rays (even on overcast days). For Swimming Days - all children 7 and under will not be permitted in the deep pool/hydroslide for safety reasons. All other children will be - however if the lifeguards do not think your child is capable of being in the deep pool they will request your child to swim half/full length of the pool as part of their rules for health and safety. Days activities may change unexpectedly so please ensure your child has appropriate clothing - e.g jackets, warm/cool clothing. Skirts/good clothing may not be appropriate. Photos/video/artwork may be used in a range of promotional materials, such as print and electronic media, including our websites and closed group pages. New enrolments will be automatically added to our mailing list
SICKNESS: Please keep your child at home if they are unwell until recovered as we do not have the facility to look after sick children. If your child attending the programme becomes unwell we will contact you to collect your child as soon as possible. Please notify the centre if your child has been diagnosed with an infectious illness straight away. If your child has had vomiting or diarrhoea either at the centre or at home they will be excluded from the programme until they have been symptom free for 48 hours.
BEHAVIOUR MANAGEMENT: You may be contacted to collect your child at the staff’s discretion and you will be liable for any costs if your child damages property. The fee is non refundable if your child has been removed from the programme
CHILDRENS PROPERTY: children are welcome to bring in toys, but it is their responsibility. Staff will not be able to look after the children’s property so this must be kept in their school bags.
Kids Domain and staff will be free and clear of all liability in the event of any injury as accidents do happen from time to time, damage or loss sustained by your child or to personal affects. A full copy of policies and procedures are available to read at each centre or by clicking here. The booking information I have given is correct and this booking forms a legally binding contract between myself and Kids Domain. Kids Domain privacy policy is governed by the New Zealand Privacy Act 2020. If you voluntarily provide personal information (eg, through email feedback or online forms), we will keep that personal information secure and will not disclose it to any third party. Any personal information supplied will only be used for the purpose for which it was provided or permitted by the Privacy Act 2020 or otherwise required by law. Any information gathered may be viewed by the Ministry of Social Development for audit purposes, in line with the Privacy Act 2020, personal information required to be utilised that relate to any unpaid fees, can be passed to a debt collection agency and/or department of courts.
YES, I HAVE READ, UNDERSTOOD & AGREE TO THE TERMS AND CONDITIONS*

Yes
Photos

No photos pleasePhotos are fine
Full Name*

First NameLast Name
Documents you would like to attach (includes winz forms, medical information, behaviour plan etc)

Upload Documents Here

Cancelof
Date Signed*
Please check your form carefully before pressing the 'submit form now' button below as booking will confirm automatically and the fee is payable
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AUTHORISED PICK UP PEOPLE: In the event of an emergency and we are unable to get hold of the parent/caregiver, it is very important we have emergency contact people (this could be friends, family, neighbours etc). Please list below: