1. family and parenting
2. children

Child’s name:
1)_____________________________________________D.O.B:____________
2)_____________________________________________D.O.B:____________
3)_____________________________________________D.O.B:____________
School Holiday Programme
Parent’s name:__________________________________________________
Address: _______________________________________________________
Home phone:___________________ Work phone:____________________
Mobile:_________________________________________________________
September/October 2014
Waitakere Gymnastics offers the ideal venue for
your children during the school holidays.
Email:__________________________________________________________
Emergency contact person:_______________________________________
Phone:_________________________________________________________
Medical information (eg. allergies):_________________________________
_______________________________________________________________
Special information (eg. child can’t swim):__________________________
_______________________________________________________________
• Large indoor fully equipped, purpose built facility
• Suitable for children aged 5-12 years
• A fun, social environment, supervised by great coaches
• Encouraging co-ordination and building confidence
Declaration & Consent:
I give consent for my child(ren) to attend Waitakere Gymnastics school holiday
programme activities and replacement activities that may be needed. This
includes using public transport and walking to venues. I will provide my child
with the required equipment for each day, including food required for the
activities. I will inform Waitakere Gymnastics staff of any special conditions or
medical information that may be required for my child(ren). I agree to co-operate
with Waitakere Gymnastics understanding that they will exercise due care but
will not be liable for any injury or damage my child(ren) may sustain to his or her
person or property. In the case of accident or illness, if considered advisable, I
request that medical attention be secured at my expense and to be notified
promptly. I agree to photos being taken of my child(ren), and used for display.
I have read and agree to the conditions in this application, and will abide by
the holiday programme policies.
Signed:_____________________________________________ Date:_______
Relationship to child:_____________________________________________
Numbers are limited. Bookings are essential.
Phone: (09) 827 5394
e-mail: office@waitakeregymnastics.co.nz
Post: PO Box 15420, New Lynn, Auckland
Location: Olympic Park, Portage Road, New Lynn, Auckland
Website: www.waitakeregymnastics.co.nz
Times
Drop off between 8.50am - 9.00am. Pick up is at 4.00pm
Activities during school holiday programme
Week 1 - September/October
Mon 29th
Cup Cake – Field Games – 3D Art
School Holiday Programme Enrolment Form
Wed 1st
Scratch Art – Pizza Making – Sports
Cut along the dotted line of this enrolment form and complete both sides.
Tue 30th
Thu 2nd
Fri 3rd
Wheels Day* – Master Chef (Get creative with food)
Rock wall – Free Choice Time – Bring a Board Game
Team Games – Playground & Picnic – Fort Building
In addition to the scheduled activities above, the children will also enjoy both
structured and supervised free play in the gymnasium.
Week 2 - October
Mon 6th
Pit Play – The Amazing Race
Tue 7th
Team Challenges – Kids Quiz – Sports
Wed 8th
Rock Wall – Mini Olympics – Waitakere’s Got Talent
Thu 9th
Halloween Crafts – Free Choice – Ultimate Obstacle Course
Fri 10th
Pyjama Party & Pancakes – Party Games – Face Painting
In addition to the scheduled activities above, the children will also enjoy both
structured and supervised free play in the gymnasium.
What to bring
Comfortable clothing - shorts & T-shirts and pack a change of clothes. Please
bring a named drink bottle & pack morning tea and lunch for your child(ren).
Please refrain from packing food that contains nuts.
*For Wheelies Day bring your bike, skateboard, scooter and helmet etc., weather
permitting. **For outdoor and water activities, kids are required to bring a sun
hat, togs, towel & change of clothes to participate and spend time outdoors.
Sunscreen supplied. Remember medication & special requirements.
Holiday programme policy
Waitakere Gymnastics reserves the right to change the programme being offered without notification. Parents must read the notice board in the foyer each day for programme information.
Parents must sign the register on delivery and pick up of their child(ren). Spaces are strictly
limited. Each day will only run with a minimum of 8 children. Refunds are only available for illness
or injury (medical certificate required) or in exceptional circumstances and at the discretion of the
Chairperson of the Waitakere Gymnastics Committee. Refunds are only available if notification
is received at least one week prior to the commencement date of the class. Children must abide
by the gym and the holiday programme rules at all times. A copy of these rules can be obtained
from the office. Children will be reminded of the rules at commencement of the class.
Send form with payment to:
Mail:
Waitakere Gymnastics, PO Box 15420, New Lynn, Auckland
Fax:
(09) 827 3549
Drop off: Head office, Olympic Park, Portage Road, New Lynn
Attendance: Tick days/hours you require
Week 1 (Sept/Oct)
($25)
($25)
($35)
Mon 29th
9-12.30pm
12.30-4pm
9-4pm
Tue 30th
9-12.30pm
12.30-4pm
9-4pm
Wed 1st
9-12.30pm
12.30-4pm
9-4pm
Thu 2nd
9-12.30pm
12.30-4pm
9-4pm
Fri 3rd
9-12.30pm
12.30-4pm
9-4pm
($25)
($25)
($35)
Mon 6th
9-12.30pm
12.30-4pm
9-4pm
Tue 7th
9-12.30pm
12.30-4pm
9-4pm
Wed 8th
9-12.30pm
12.30-4pm
9-4pm
Thu 9th
9-12.30pm
12.30-4pm
9-4pm
Fri 10th
9-12.30pm
12.30-4pm
9-4pm
Week 2 (Oct)
Specials:
Full Time (9-4pm) for a full week = $150.00
Full Time (9-4pm) for all 10 days = $300.00
Total amount
Payment must be made to secure your child(ren)’s place
Cash
Eftpos
Cheque
Internet Banking
Please make cheques payable to Waitakere Gymnastics
Bank account details: ASB 12-3070-0083597-00
$ Amount
$ Amount