• Enrolment Form

    Please note, there are several mandatory sections in this form. This form requires payment by credit/debit card in order to be submitted. If you have any questions, or cannot complete credit/debit card payment, please write to us at stars.enquiries@starsprogrammes.co.nz or contact Janine at 0210660261
  • Enter Email Address*
  •  -
  •  -

  • Child 1

    Please fill in the following to enrol your first child, there will be opportunity to enrol more children later. This section is for ONE child only.
  • Date of Birth*
     - -
    2 digit day, 2 digit month, 4 digit year
  • Gender*
  • Days Attending - It is the parent's / guardian's responsibility to inform us of any changes to the child's attendance. Please select the days you will attend.*

  • Learning Experience Preferences

    For Child 1
  • ONE choice only for the whole time - For maximum learning experience we require that your child stays in the same activity for the duration of the programme.*

  • Learning Experience Preferences

    For Child 1
  • ONE choice only for the whole time - For maximum learning experience we require that your child stays in the same activity for the duration of the programme.*

  • Intermediate Programme

  • Our intermediate program has a 'no cell phone' policy. By enrolling your child, you consent to us enforcing our policy. While children can bring their cell phones for emergency purposes, we require these to remain in their bags. 

     

    For the intermediate programme, we will hold offsite activities which may require us to use transport or visit venues (e.g. Hamilton Gardens, museums). Please advise whether you consent to your child attending offsite activities. Tick "Yes' if you consent to your intermediate child attending offsite activities.

  • Health and Medical Information

  • Does your child have any medical conditions, allergies, disabilities, or health concerns that staff should be aware of?*
  • Does your child require medication while attending the programme?*

  • If Yes, please complete the Medication Administration and Self-Medication Plan before your child's first day attending.

  • Does your child have permission to self-administer medication?*

  • Medication Administration and Self-Medication Plan

    This medication administration and self-medication plan is in accordance with OSCAR guidelines
  •  -

  • Medication Details

  • Method of administration*
  • Storage Requirements
  • Expiry Date*
     - -
    2 digit day, 2 digit month, 4 digit year

  • Parent/Caregiver Instructions

  • Emergency Action Plan

    If medication does not improve the child's condition, staff should:
  • Call an ambulance?*

  • Self-Medication Plan

  • Will the child self-administer this medication?*
  • Parent declaration - I confirm my child:

  • Parent/Caregiver authorisation

  • I authorise the programme to administer medication to my child as described above or, where approved, to allow my child to self-administer their medication according to this plan.

    I agree to:

    • supply medication in its original pharmacy-labelled container (where applicable);
    • ensure the medication is within its expiry date;
    • immediately advise the programme of any changes to the medication, dosage, or instructions; and
    • provide a new medication plan if circumstances change.
  • Date
     - -
    2 digit day, 2 digit month, 4 digit year
  • Would you like to enrol another child?*

  • Child 2

    Please fill in the following to enrol your child. This section is for ONE child only.
  • Date of Birth*
     - -
    2 digit day, 2 digit month, 4 digit year
  • Gender*
  • Days Attending - It is the parent's / guardian's responsibility to inform us of any changes to the child's attendance. Please select the days you will attend.*

  • Learning Experience Preferences

    For Child 2
  • ONE choice only for the whole time - For maximum learning experience we require that your child stays in the same activity for the duration of the programme.*

  • Learning Experience Preferences

    For Child 2
  • ONE choice only for the whole time - For maximum learning experience we require that your child stays in the same activity for the duration of the programme.*

  • Intermediate Programme

  • Our intermediate program has a 'no cell phone' policy. By enrolling your child, you consent to us enforcing our policy. While children can bring their cell phones for emergency purposes, we require these to remain in their bags.

    For the intermediate programme, we will hold offsite activities which may require us to use transport or visit venues (e.g. Hamilton Gardens, museums). Please advise whether you consent to your child attending offsite activities. Tick "Yes' if you consent to your intermediate child attending offsite activities.

  • Health and Medical Information

  • Does your child have any medical conditions, allergies, disabilities, or health concerns that staff should be aware of?*
  • Does your child require medication while attending the programme?*

  • If Yes, please complete the Medication Administration and Self-Medication Plan before your child's first day attending.

  • Does your child have permission to self-administer medication?*

  • Medication Administration and Self-Medication Plan

    This medication administration and self-medication plan is in accordance with OSCAR guidelines
  •  -

  • Medication Details

  • Method of administration*
  • Storage Requirements
  • Expiry Date*
     - -
    2 digit day, 2 digit month, 4 digit year

  • Parent/Caregiver Instructions

  • Emergency Action Plan

    If medication does not improve the child's condition, staff should:
  • Call an ambulance?*

  • Self-Medication Plan

  • Will the child self-administer this medication?*
  • Parent declaration - I confirm my child:

  • Parent/Caregiver authorisation

  • I authorise the programme to administer medication to my child as described above or, where approved, to allow my child to self-administer their medication according to this plan.

    I agree to:

    • supply medication in its original pharmacy-labelled container (where applicable);
    • ensure the medication is within its expiry date;
    • immediately advise the programme of any changes to the medication, dosage, or instructions; and
    • provide a new medication plan if circumstances change.
  • Date
     - -
    2 digit day, 2 digit month, 4 digit year
  • Would you like to enrol another child?*

  • Child 3

    Please fill in the following to enrol your child. This section is for ONE child only.
  • Date of Birth*
     - -
    2 digit day, 2 digit month, 4 digit year
  • Gender*
  • Days Attending - It is the parent's / guardian's responsibility to inform us of any changes to the child's attendance. Please select the days you will attend.*

  • Learning Experience Preferences

    For Child 3
  • ONE choice only for the whole time - For maximum learning experience we require that your child stays in the same activity for the duration of the programme.*

  • Learning Experience Preferences

    For Child 3
  • ONE choice only for the whole time - For maximum learning experience we require that your child stays in the same activity for the duration of the programme.*

  • Intermediate Programme

  • Our intermediate program has a 'no cell phone' policy. By enrolling your child, you consent to us enforcing our policy. While children can bring their cell phones for emergency purposes, we require these to remain in their bags.

    For the intermediate programme, we will hold offsite activities which may require us to use transport or visit venues (e.g. Hamilton Gardens, museums). Please advise whether you consent to your child attending offsite activities. Tick "Yes' if you consent to your intermediate child attending offsite activities.

  • Health and Medical Information

  • Does your child have any medical conditions, allergies, disabilities, or health concerns that staff should be aware of?*
  • Does your child require medication while attending the programme?*

  • If Yes, please complete the Medication Administration and Self-Medication Plan before your child's first day attending.

  • Does your child have permission to self-administer medication?*

  • Medication Administration and Self-Medication Plan

    This medication administration and self-medication plan is in accordance with OSCAR guidelines
  •  -

  • Medication Details

  • Method of administration*
  • Storage Requirements
  • Expiry Date*
     - -
    2 digit day, 2 digit month, 4 digit year

  • Parent/Caregiver Instructions

  • Emergency Action Plan

    If medication does not improve the child's condition, staff should:
  • Call an ambulance?*

  • Self-Medication Plan

  • Will the child self-administer this medication?*
  • Parent declaration - I confirm my child:

  • Parent/Caregiver authorisation

  • I authorise the programme to administer medication to my child as described above or, where approved, to allow my child to self-administer their medication according to this plan.

    I agree to:

    • supply medication in its original pharmacy-labelled container (where applicable);
    • ensure the medication is within its expiry date;
    • immediately advise the programme of any changes to the medication, dosage, or instructions; and
    • provide a new medication plan if circumstances change.
  • Date
     - -
    2 digit day, 2 digit month, 4 digit year

  • If you would like to enrol 4 or more children, please contact us at stars.enquiries@starsprogrammes.co.nz

  • Authorised persons to collect your child/children

  • Other than the people mentioned on the previous page, is there anyone else authorised to transport your child?*
  •  -
  •  -
  •  -

  • Person/s not permitted to collect your child/children

  • Self Sign-In and Sign-Out Permission

    Authorisation for My Child to Sign Themselves In and Out.

  • Some children may be permitted to arrive and leave the programme independently. If you wish your child to be allowed to sign themselves in and out, please complete this section.

  • I give permission for my child to sign themselves in and out of the programme without being dropped off or collected by an authorised adult.*
  • If Yes, this permission applies:*
  • Only on specific days
  • Times the child is allowed to sign themselves out*
  • Method of arriving/leaving:
  • Parent Declaration

  • I understand that once my child has signed themselves out and left the programme, they are no longer under the supervision or responsibility of the programme. I authorise the programme to allow my child to leave independently in accordance with the instructions above.

  • Date*
     - -
    2 digit day, 2 digit month, 4 digit year

  • Intersite transportation

    We are now providing free intersite transport from our Primary Programme to our Intermediate Programme every day during the Stars Programme - available if you have children enrolled in both programmes.

  •  

    Schedule:
    9:15 A.M. Primary site (Beale Street) → Intermediate site (Gordonton Road)
    2:45 P.M. Intermediate site (Gordonton Road) → Primary site (Beale Street), arriving at approximately 3:00 P.M.

    This is applicable ONLY if:
    1. You have both enrolled primary and intermediate children.
    2. You agree to sign in and sign out your intermediate children at the Primary Programme site (Beale Street)
    3. Intermediate children must arrive at the Beale Street site before 9:15 A.M. every morning and be picked up at Beale Street from 3:00 P.M to 3:15 P.M. We will leave on time at 9:15 A.M. every morning.

    We reserved the right to assess every request. We will contact you about the arrangements before the programme begins. 

     

  • Please tick if you request intersite transportation

  • Additional information for Staff

    Is there anything else you would like our staff to know to help us care for your child/children or support their participation in the programme?

  • Terms & Conditions

  • By enrolling your children in this programme you agree and acknowledge:

    – That you have read and understand the enrolment information on this website.

    – That the staff have your permission to arrange any necessary urgent medical treatment at your cost.

    – That you will notify the staff of any changes to enrolment information in a timely fashion.

    – That you will pay the fees as stipulated on the Fees page.

    – We reserve the right to deny enrolment to any child if the information supplied is inaccurate.

    - Fees are non-refundable.

    Privacy Act 2020: The information that you have supplied is necessary for the safe and effective operation of the OSCAR programme. This information will only be viewed by Stars Holiday Programme Staff or Child, Youth and Family. All personal information requested will be destroyed at the completion of your child’s time in the programme. You are welcome to review information pertaining to your child’s enrolment at any time.

    We reserve the right to take photos of activities and children participating in those activities for internal and promotional purposes. By enrolling a child in the Stars Holiday Programme, you give consent for photos to be taken of that child. If you do not wish for photos of the enrolled child to be taken or used, you must state this in writing to stars.enquiries@starsprogrammes.co.nz

    Where there are concerns for the safety of a child or another family member, Stars Holiday Programme may share your information with the appropriate organisations.

    Our paramount consideration in all our decisions is children’s safety and well-being. For this reason, although we will respect the privacy and confidentiality of the children and their families, there is a limitation to this. Confidentiality cannot be absolute because our duty of confidentiality is balanced by our duty to ensure the safety, well-being and protection of children or others.

    All care will be taken to provide supervision of children attending the programme in accordance with programme policies and procedures.

    If you have any questions about the programme or wish to see a copy of the programme policies, please do not to hesitate to ask a member of staff.

  • Date*
     - -
    2 digit day, 2 digit month, 4 digit year

  • Payment

  • **Out of town discount applies - please use code NZTC40

  • Same fee applies to full or part attendance, the discount only applies to siblings.*

    prevnext( X )
              1 Child $200
              $200.00 NZD$200.00NZD
                
              2 Children $260
              $260.00 NZD$260.00NZD
                
              3 Children $320
              $320.00 NZD$320.00NZD
                
              OSCAR - requires WINZ confirmation
              Free$ FreeNZD
                
              Intermediate outing

              This is an outing on Monday for those in the Intermediate programme. Please select this in addition to the fee. The cost is $20 per child. Quantity is 1 per child.

              $20.00 NZD$20.00NZD
              Item subtotal:$0.00 NZD$0.00NZD
                
              Total
              $0.00 NZD$0.00NZD
              Debit or Credit Card

            • **As you have selected OSCAR, enrolment is not secured until we have received a confirmation from WINZ.

            • Should be Empty: