Child Registration Form

Child Registration Form

Church in Auckland Holiday Programme
This programme is for primary school children only.

We are not able to accommodate children under 5 years old.

Please do not use this form if your child has special needs. We are a group of church volunteers and workers who do not have the staffing or expertise to care for children that require special care. Instead, please contact us at children@churchinauckland.org.nz first to discuss before registration deadline.

We welcome intermediate school children to also register using this Child registration form as a Trainee Helper and pay half fees. The fees will cover the training, meals, participation in crafts and any special activities arranged for them. Please discuss with your child that they are expected to help.

Locations:
St. Lukes - 71 Morningside Dr

Onehunga - 30 Upper Municipal Pl

Albany - 29 Omega St

Dates:
Monday-Friday, 9am-3pm
28 Sept-2 Oct 2026

Early Fees, including food, per child：
Primary age child fee = $160 per week (or $40 per day)
Intermediate age child fee = $80 per week (or $20 per day)

Fees after 13 Sept

Primary and Intermediate age child fee = $50 per day

Medical Conditions
Please be advised that if your child has a medical condition which requires specific monitoring and care, we do not have the expertise or staffing to care for him/her. You may contact us at children@churchinauckland.org.nz for further discussion regarding enrolling your child. The following conditions may require some further discussion with you for acceptance of enrolment. Please tick if your child has any of the following conditions:

Other
If your child needs to bring their own medication such as an epipen or asthma inhaler, please note here what will be brought and if your child is allowed to self-administer. Otherwise please describe any other medical condition which may affect your child's participation in the programme.
Behavioural Issues

Please be advised that if your child has a known or suspected behavioural/developmental condition with special needs, we do not have the expertise or staffing to care for him/her and we are unable to accept enrolment. To enrol in the program we require the following agreement. If you have any questions and would like further discussion regarding your child or wish to attend along with your child to enable their enrolment, please contact us at children@churchinauckland.org.nz. Thank you for your understanding.
I declare that my child has not had serious behavioural issues that needed to be addressed at school or in any other programme. This includes but is not limited to violent outbursts, hitting others, and other difficult to manage behaviour that has required extra staff to address and that would be knowingly beyond this programme's staffing and expertise.

Contact Information
Parent 1 - Full Name
Parent 1 - Mobile Number
Email
example@example.com
Emergency Contact #1 (if parent cannot be contacted)
Name and phone number
Emergency Contact #2 (if parent cannot be contacted)
Name and phone number
Please provide names of people who are authorised to pick up your child/children
Please provide any names of people who are NOT authorised to pick up your child/children. (If one parent is unauthorised then you may be asked to provide evidence.)
How do you know about our programme?
Is this your first time to join our programme?
We welcome you and your child to the programme!

Seeds is run mostly by church volunteers, including parents, university students, and other church members who have a heart for children. Since we are a 'home-grown' cooperative programme, we may take an extra step to contact you for finalising your enrolment the programme, to arrange a call or visit with your family. This is so we can get to know your family and understand your expectations of us, find out more about your child, and for you to learn more about how our 'home-grown' programme is run.
Please tell us the name of your friend who introduced you to our programme.

Terms and Conditions

Please read the following thoroughly. Registration is only accepted with agreement to all terms and conditions.
Medical Consent: In the unlikely event of serious injury or accident, I give consent for programme staff to contact me and medical personnel if required and for my child/children to receive medical attention. First aid attention will otherwise be provided by first aid-certified programme staff for injuries or accidents. Programme staff are not responsible for administering medication brought by parents.
Child Behaviour: If there are issues with my child/children with regard to dangerous or violent behaviour, or otherwise behaviour that is beyond the ability of staff to handle, I agree to be contacted to take my child home and I understand that my child may be removed from the programme thereafter. If my child has intentionally caused any damage to property, I can be held responsible for replacing the damaged property or providing monetary compensation.
Photographs: As part of this programme, my child/children's photographs will be taken. I understand that these photographs would be for personal use, a participation certificate, marketing, and/or digital presentation.
Sickness: If my child and/or I as a helper am sick with any symptom of stomach ache, nausea, congested nose, cough, sore throat, fever, diarrhea, vomiting or any other symptom that is of a contagious and/or serious nature, I agree that my child and/or I should not attend the programme. Programme staff reserve the right to send children and helpers home if they are found to have such symptoms on arrival, out of caution and safety of others.
Refund Policy: Fees are non-refundable except for sickness.
Privacy: Information provided in this registration form may be retained and used for statistical and planning purposes by programme staff. All effort is made to maintain your privacy. Any personal information provided is only accessed by programme staff and may be used for correspondence regarding future programmes and/or events. Programme staff reserve the right to share information with the appropriate authorities if there is any serious concern regarding the well-being and safety of any child in the programme.
Off-site: If staff elect to transport children you provide consent for your child/children to travel with staff or other parents. All effort would be made to reduce risk with travel, including walking on public roads. An example would include walking across the carpark to the gym in Onehunga or being transported by cars to visit an offsite park.
Electronic signature

First NameLast Name

Debit or Credit Card
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Credit Card Number	Security Code
Expiration Month	Expiration Year

Child Registration Form

Child Information

Medical Conditions

Behavioural Issues

Contact Information

Terms and Conditions

Payment

Days my Child will Attend

Enter coupon

Child Registration Form

Child Information

Medical Conditions

Behavioural Issues

Contact Information

Terms and Conditions

Payment

Days my Child will Attend*

Days my Child will Attend