Nature'sCool  - Term 1 Holidays (2020) sign up form.
Please complete this form if you want to book your child(ren) in for the Nature'sCool -Term 1 Holiday programme based in Huanui / Glenbervie (Whangarei).

Note - Please fill in this form even if you have booked with us in the past. However, If you would like to amend your booking or book additional days during the Term 1 Holidays, please just email safeoutdoorsnz@gmail.com with the additional dates and I will simply transfer your information (no need to fill this form again).

 FYI: We are also running "Limestone Rangers" Holiday Programme during these holidays. Here's the link if you wish to book:  

Finally - a reminder that we have Earth's Kitchen Sunscreen for sale to our customers at $34 / tube (which is $4 off). If you would like to order some, just fill in the question at the bottom.

Thanks so much for your support! Luke, Hilary & Emma.
Sign in to Google to save your progress. Learn more
Email *
Parent name *
Parents contact phone number *
Alternative Emergency contact number (different than above) *
How many children are you signing up? *
What is your child / children's full name(s)? And how old are they? *
Does your child have any medical conditions we should know about? - (please include for each child: symptoms, treatment and emergency response if necessary) *
Does your child have any behavioral or learning characteristics that we should know about? (please include a description for each child if necessary). *
Does your child(ren) have any food allergies we should know about? (please include a description for each child if necessary)
In the event of an incident / accident or emergency, do you give Safe Outdoors NZ staff permission to administer "over the counter" medication - including paracetamol, antihistamines or Ventolin (blue inhaler) to your child(ren)? *
If your child is under 6 years of age then they must be accompanied by a (full paying) older sibling or close friend who is 7 years or older- please detail below
What date(s) are you wanting to attend in Week 1? (you can tick more than one)
Tues 14th April
Running Limestone Rangers on Wed
Thurs 16th April
Fri 17th April
Row 1
What date(s) are you wanting to attend in Week 2? (you can tick more than one)
Mon 20th April
Tues 21st April
Wed 22nd April
Thurs 23rd April
Fri 24th April
Row 1
Media Release: please let us know if you / your child(ren) are comfortable with photos / videos of your child(ren) being used on our social media site(s) and / or our website? *
Authorisation: By ticking "Agree" below, you as a guardian of the child or children (listed above), agree to the terms and conditions as outlined on the website https://safeoutdoors.co.nz/naturescool-holiday *
Required
Pick up time & after hours supervision request: Please select the pick up option which applies to you and add the corresponding amount to your total payment in the question below:
3.15 - 3.30pm (no extra charge)
3.30 - 3.45pm (+ $6.50) per person
3.45 - 4pm (+ $13 ) per person
4 - 4.15pm (+ $19.50 ) per person)
4.15 - 4.30pm (+$26) per person
Huanui College
Earth's Kitchen Sunscreen order:  Click here to order Kawakawa & Tamanu SPF50+ certified natural sun protection for adults & children (including babies). (120ml) - Price = $34 each. Please write below how many you would like, and whether you will pick up or need it posted (please include address  + $6 postage).
Please write below a brief summary of what you are paying for e.g:     1x child / single day + 1 x Sunscreen (pick up) = $79        or          (2 x children / single day ) = $90     or     (1 x child / 2 x days + $13 late pick up Huanui both days = $113) *
Payment: To confirm your child(ren)'s place in the programme - please make a Direct bank transfer to ANZ account: "Safe Outdoors NZ Ltd" - 01-0877-0763805-00. Please put the code "NC" (+ EK if ordering Sunscreen) followed by your child's last name in the reference. *
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy
Google Forms