» Enrolment Form

PLEASE NOTE 

 - payment must be made at time of enrolment. Online enrolments close at 3 pm on Friday 28th September.  You will still be able to enrol your children in the programme by coming in to the Centre after this date.

       Some Activities have limited numbers you will be notified if the activity your child is enrolled in is full

****  Sailing is no longer available ****    

Parents wanting to attend trips and extra child enrolments can be added at the bottom of the enrolment form

 

- please read important parent information before your child attends the programme

- if your child is going on a trip or an activity that is not held at the Community Centre there may be important things they need to bring with them.  Please check the Information Sheets for Trips and Activities.

 

We welcome parents/caregivers to join their child  on the trips please enrol at the bottom of the enrolment form.
 
Parents and caregivers are more than welcome to stay and join in the fun with their child with the cooking and craft activities please let staff know if you will be joining us.
 
Please Note: All adult helpers (aged 17 and over) must complete a police vetting form and email it to admin@katikaticommunity.nz or drop it off to the Katikati Community Centre before going on School Holiday Programme trips.

Child's Name *
Child's Gender *
 Male
 Female
Child's Date of Birth *
Child's Age
Address *
Phone (home) *
Phone (work)
Phone (cell)
Email *
Ethnicity
Emergency Contact Name *
Emergency Contact Number *
IMPORTANT! Please provide names of people who will collect your child. E.g.LYNNE (Mum), walk home *
Doctors Name/Clinic
Swimming Ability *
Medical Condition/Special Needs/Custody *
Please outline condition or requirements.
Are you happy to have your child/children photographed for media/promotional purposes? *
Permission: I hereby give permission for my child to take part in the School Holiday Programme which is being organised and supervised by the Katikati Community Centre or their agents. I acknowledge that the Katikati Community Centre or their agents will take all care of my child but will not be held liable for any injury to him/her during the activity. Privacy Act 1993: The Katikati Community Centre wishes to collect the written details for registration purposes, this information will be accessible to Community Centre Staff only (For auditing purposes information gathered may be viewed by Ministry of Social Development. *
 I agree
WEEK 1 Monday 1st October
 1A Spring Time crafts morning Age 5+ 9.00am - 12.30pm $7 Held off site
 1B Spring Time crafts afternoon Age 5+ 1.30pm - 3.00pm $7 Held off site
 1C x 3 Football Clinic x 3 Days 7-12years $75
 1C Football Clinic Monday 7-12 years 9.30am-3.00pm $30
 1D Kiwisport Age 7+ 9am - 3pm $8
 1E String Pictures 9+ 9am-3pm $14
 1M Before Care starts 8am $6
 1 After Care finishes 4pm $6
Tuesday 2nd October
 2A Future Fun morning Age 5+ 9am - 12.30pm $7
 2B Future Fun afternoon Age 5+ 1.30pm- 3.00pm $7
 2C Football Clinic Tuesday 7-12 years 9.30am - 3pm $30
 2E Horse Riding 9.00am - 1.15pm Age 8+ $20
 2F Pool fun Age 7+ 1pm - 3pm $4
 2G Rock Art Age 9+ 9.00am - 3.00pm $14
 2M Before Care starts 8am $6
 2 Aftercare finishes 4pm $6
Wednesday 3rd October
 3A Chipmunks Trip Age 5-10 years 8.30am - 3.00pm $19
 3C Football Clinic Wednesday Age 7-12 years 9.30am - 3pm $30
 3D Sports Day Age 7+ 9am-3pm $8
 3E Be Creative Age 9+ 9.00am - 3.00pm $14
 3M Before Care starts 8am $6
 3 After Care finishes 4pm $6
Thursday 4th October
 4A Amphibians craft & cooking morning Age 5+ 9am - 12.30pm $7
 4B Amphibians craft & cooking morning Age 5+ 1.30pm - 3.00pm $7
 4C Games Day Age 7+ 9am-3pm $8
 4D Lets Go Bush Age 9+ 8.45am - 3.15pm $16
 4M Before Care starts 8am $6
 4 After Care finishes 4pm $6
Friday 5th October
 5A Muppet Mania morning Age 5+ 9am - 12.30pm $7
 5B Muppet Mania afternoon Age 5+ 1.30pm - 3.00pm $7
 5C Kiwisport morning Age 7+ 9am - 12.30pm $4
 5D Dodgeball afternoon Age 7+ 1pm - 3pm $4
 5F Smallfoot Movie & Hotpools Age 5+ (6 years and under needs an adult) 8.30am - 3.15pm $25
 POP popcorn for movie trip $6
 ICE icecream for movie trip $5
 5M Before Care starts 8am $6
 5 After Care finishes 4pm $6
WEEK 2 Monday 8th October
 8A Awesome Art morning Age 5+ 9am-12.30pm $7
 8B Awesome Art afternoon Age 5+ 1.30pm - 3.00pm $7
 8C Kiwisport Age 7+ 9am - 12.30pm $4
 8T5 Tennis Age 5-7 years 1pm-2pm $5
 8T8 Tennis Age 8-12 years 2pm - 4pm $10
 8D Pool Fun Age 7+ 1pm - 3pm $4
 8E Learn to Sail Age 10+ 9am - 3pm $25
 8M Before Care starts 8am $6
 8 After Care finishes 4pm $6
Tuesday 9th October
 9A Be Creative morning Age 5+ 9am - 12.30pm $7
 9B Be Creative afternoon Age 5+ 1.30pm - 3.00pm $7
 9C Fun Sport morning Age 7+ 9am -12.30pm $4
 9D Dodgeball afternoon Age 7+ 1pm - 3pm $4
 9T5 Tennis Age 5-7 years 1pm - 2pm $5
 9T8 Tennis Age 8-12 years 2pm-4pm $10
 9E Horse Riding Age 8+ 9am - 1.15pm $20
 9F Rainbow Springs Rotorua Age 6+ (7 years and under need an adult) 8.15am - 3.30pm $29
 9M Before Care starts 8am $6
 9 After Care finishes 4pm $6
Wednesday 10th October
 10A Make Believe crafts & cooking Age 5+ 9.00am - 12.30pm $7
 10B Make Believe crafts & cooking Age 5+ 1.30pm - 3.00pm $7
 10C Action Fun and Games Age 7+ 9am - 12.30pm $4
 10T5 Tennis Age 5-7 years 1pm - 2pm $5
 10T8 Tennis Age 8-12 years 2pm - 4pm $10
 10E Pool Fun Age 7+ 1pm - 3pm $4
 10F Kids Market Age 6+ (7 years and under need an adult) 9am - 12noon no charge
 10M Before Care starts 8am $6
 10 After Care finishes 4pm $6
Thursday 11th October
 11A Fairy Tale crafts morning Age 5+ 9am - 12.30pm $7
 11B Fairy Tale crafts afternoon Age 5+ 1.30pm - 3.00pm $7
 11C Wrestling Age 7-13years 9am - 12.30pm $5
 11D King Seeds Age 7-11 years 1pm - 3pm $5
 11E Movie & Tenpin Bowling Age 9+ 8.30am - 3.15pm $27
 11M Before Care starts 8am $6
 11 After Care finishes 4pm $6
Friday 12th October
 12A Silly Spooky morning Age 5+ 9am - 12noon $7
 12B Party Time & Movie afternoon Age 5+ 12noon - 3pm $7
 12C Laser Tag & Hotpools Age 9+ 8.15am - 3.00pm $28
 12M Before Care starts 8am $6
 12 After Care finishes 4pm $6
PARENTS NAME if coming on a trip (All adults 18 years and over must be police vetted) Please tick the trip you you will join your child on
 3A Adult Chipmunks, no charge to watch
 4D Adult Lets go bush (must be fit) no charge
 5F Adult Small foot movie & hotpools $13.50 for Movie
 5F Adult Smallfoot movie & hotpools $5 to Swim
 9F Adult Rainbow Springs Rototua, includes the big splash $24
 11D Adult Grow inspired - Kings seeds no charge to accompany child
 11E Adult Movie & Tenpin, $13.50 for Movie
 11E Adult Movie & Tenpin, $6.00 to Play Tenpin
 12C Adult Laser Tag & Hotpools - to play laser Tag $16
 12C Adult Laser Tag & Hotpools - to swim
2ND CHILD: Name
2nd Child: Gender
 Male
 Female
2nd Child: Date of Birth
2nd Child: Age
2nd Child: Swimming Ability
2nd Child: Medical or other information we need to know
WEEK 1 Monday 1st October
 1A Spring Time crafts morning Age 5+ 9.00am - 12.30pm $7 Held off site
 1B Spring Time crafts afternoon Age 5+ 1.30pm - 3.00pm $7 Held off site
 1C x 3 Football Clinic x 3 Days 7-12years $75
 1C Football Clinic Monday 7-12 years 9.30am-3.00pm $30
 1D Kiwisport Age 7+ 9am - 3pm $8
 1E String Pictures 9+ 9am-3pm $14
 1M Before Care starts 8am $6
 1 After Care finishes 4pm $6
Tuesday 2nd October
 2A Future Fun morning Age 5+ 9am - 12.30pm $7
 2B Future Fun afternoon Age 5+ 1.30pm- 3.00pm $7
 2C Football Clinic Tuesday 7-12 years 9.30am - 3pm $30
 2E Horse Riding 9.00am - 1.15pm Age 8+ $20
 2F Pool fun Age 7+ 1pm - 3pm $4
 2G Rock Art Age 9+ 9.00am - 3.00pm $14
 2M Before Care starts 8am $6
 2 Aftercare finishes 4pm $6
Wednesday 3rd October
 3A Chipmunks Trip Age 5-10 years 8.30am - 3.00pm $19
 3C Football Clinic Wednesday Age 7-12 years 9.30am - 3pm $30
 3D Sports Day Age 7+ 9am-3pm $8
 3E Be Creative Age 9+ 9.00am - 3.00pm $14
 3M Before Care starts 8am $6
 3 After Care finishes 4pm $6
Thursday 4th October
 4A Amphibians craft & cooking morning Age 5+ 9am - 12.30pm $7
 4B Amphibians craft & cooking morning Age 5+ 1.30pm - 3.00pm $7
 4C Games Day Age 7+ 9am-3pm $8
 4D Lets Go Bush Age 9+ 8.45am - 3.15pm $16
 4M Before Care starts 8am $6
 4 After Care finishes 4pm $6
Friday 5th October
 5A Muppet Mania morning Age 5+ 9am - 12.30pm $7
 5B Muppet Mania afternoon Age 5+ 1.30pm - 3.00pm $7
 5C Kiwisport morning Age 7+ 9am - 12.30pm $4
 5D Dodgeball afternoon Age 7+ 1pm - 3pm $4
 5F Smallfoot Movie & Hotpools Age 5+ (6 years and under needs an adult) 8.30am - 3.15pm $25
 POP popcorn for movie trip $6
 ICE icecream for movie trip $5
 5M Before Care starts 8am $6
 5 After Care finishes 4pm $6
WEEK 2 Monday 8th October
 8A Awesome Art morning Age 5+ 9am-12.30pm $7
 8B Awesome Art afternoon Age 5+ 1.30pm - 3.00pm $7
 8C Kiwisport Age 7+ 9am - 12.30pm $4
 8T5 Tennis Age 5-7 years 1pm-2pm $5
 8T8 Tennis Age 8-12 years 2pm - 4pm $10
 8D Pool Fun Age 7+ 1pm - 3pm $4
 8E Learn to Sail Age 10+ 9am - 3pm $25
 8M Before Care starts 8am $6
 8 After Care finishes 4pm $6
Tuesday 9th October
 9A Be Creative morning Age 5+ 9am - 12.30pm $7
 9B Be Creative afternoon Age 5+ 1.30pm - 3.00pm $7
 9C Fun Sport morning Age 7+ 9am -12.30pm $4
 9D Dodgeball afternoon Age 7+ 1pm - 3pm $4
 9T5 Tennis Age 5-7 years 1pm - 2pm $5
 9T8 Tennis Age 8-12 years 2pm-4pm $10
 9E Horse Riding Age 8+ 9am - 1.15pm $20
 9F Rainbow Springs Rotorua Age 6+ (7 years and under need an adult) 8.15am - 3.30pm $29
 9M Before Care starts 8am $6
 9 After Care finishes 4pm $6
Wednesday 10th October
 10A Make Believe crafts & cooking Age 5+ 9.00am - 12.30pm $7
 10B Make Believe crafts & cooking Age 5+ 1.30pm - 3.00pm $7
 10C Action Fun and Games Age 7+ 9am - 12.30pm $4
 10T5 Tennis Age 5-7 years 1pm - 2pm $5
 10T8 Tennis Age 8-12 years 2pm - 4pm $10
 10E Pool Fun Age 7+ 1pm - 3pm $4
 10F Kids Market Age 6+ (7 years and under need an adult) 9am - 12noon no charge
 10M Before Care starts 8am $6
 10 After Care finishes 4pm $6
Thursday 11th October
 11A Fairy Tale crafts morning Age 5+ 9am - 12.30pm $7
 11B Fairy Tale crafts afternoon Age 5+ 1.30pm - 3.00pm $7
 11C Wrestling Age 7-13years 9am - 12.30pm $5
 11D King Seeds Age 7-11years 1pm - 3pm $5
 11E Movie & Tenpin Bowling Age 9+ 8.30am - 3.15pm $27
 11M Before Care starts 8am $6
 11 After Care finishes 4pm $6
Friday 12th October
 12A Silly Spooky morning Age 5+ 9am - 12noon $7
 12B Party Time & Movie afternoon Age 5+ 12noon - 3pm $7
 12C Laser Tag & Hotpools Age 9+ 8.15am - 3.00pm $28
 12M Before Care starts 8am $6
 12 After Care finishes 4pm $6
3RD CHILD: Name
3rd Child: Gender
3rd child: Date of Birth
3rd Child: Age
3rd Childs Swimming Ability
3rd Child: Medical or other information we need to know
WEEK 1 Monday 1st October
 1A Spring Time crafts morning Age 5+ 9.00am - 12.30pm $7 Held off site
 1B Spring Time crafts afternoon Age 5+ 1.30pm - 3.00pm $7 Held off site
 1C x 3 Football Clinic x 3 Days 7-12years $75
 1C Football Clinic Monday 7-12 years 9.30am-3.00pm $30
 1D Kiwisport Age 7+ 9am - 3pm $8
 1E String Pictures 9+ 9am-3pm $14
 1M Before Care starts 8am $6
 1 After Care finishes 4pm $6
Tuesday 2nd October
 2A Future Fun morning Age 5+ 9am - 12.30pm $7
 2B Future Fun afternoon Age 5+ 1.30pm- 3.00pm $7
 2C Football Clinic Tuesday 7-12 years 9.30am - 3pm $30
 2E Horse Riding 9.00am - 1.15pm Age 8+ $20
 2F Pool fun Age 7+ 1pm - 3pm $4
 2G Rock Art Age 9+ 9.00am - 3.00pm $14
 2M Before Care starts 8am $6
 2 Aftercare finishes 4pm $6
Wednesday 3rd October
 3A Chipmunks Trip Age 5-10 years 8.30am - 3.00pm $19
 3C Football Clinic Wednesday Age 7-12 years 9.30am - 3pm $30
 3D Sports Day Age 7+ 9am-3pm $8
 3E Be Creative Age 9+ 9.00am - 3.00pm $14
 3M Before Care starts 8am $6
 3 After Care finishes 4pm $6
Thursday 4th October
 4A Amphibians craft & cooking morning Age 5+ 9am - 12.30pm $7
 4B Amphibians craft & cooking morning Age 5+ 1.30pm - 3.00pm $7
 4C Games Day Age 7+ 9am-3pm $8
 4D Lets Go Bush Age 9+ 8.45am - 3.15pm $16
 4M Before Care starts 8am $6
 4 After Care finishes 4pm $6
Friday 5th October
 5A Muppet Mania morning Age 5+ 9am - 12.30pm $7
 5B Muppet Mania afternoon Age 5+ 1.30pm - 3.00pm $7
 5C Kiwisport morning Age 7+ 9am - 12.30pm $4
 5D Dodgeball afternoon Age 7+ 1pm - 3pm $4
 5F Smallfoot Movie & Hotpools Age 5+ (6 years and under needs an adult) 8.30am - 3.15pm $25
 POP popcorn for movie trip $6
 ICE icecream for movie trip $5
 5M Before Care starts 8am $6
 5 After Care finishes 4pm $6
WEEK 2 Monday 8th October
 8A Awesome Art morning Age 5+ 9am-12.30pm $7
 8B Awesome Art afternoon Age 5+ 1.30pm - 3.00pm $7
 8C Kiwisport Age 7+ 9am - 12.30pm $4
 8T5 Tennis Age 5-7 years 1pm-2pm $5
 8T8 Tennis Age 8-12 years 2pm - 4pm $10
 8D Pool Fun Age 7+ 1pm - 3pm $4
 8E Learn to Sail Age 10+ 9am - 3pm $25
 8M Before Care starts 8am $6
 8 After Care finishes 4pm $6
Tuesday 9th October
 9A Be Creative morning Age 5+ 9am - 12.30pm $7
 9B Be Creative afternoon Age 5+ 1.30pm - 3.00pm $7
 9C Fun Sport morning Age 7+ 9am -12.30pm $4
 9D Dodgeball afternoon Age 7+ 1pm - 3pm $4
 9T5 Tennis Age 5-7 years 1pm - 2pm $5
 9T8 Tennis Age 8-12 years 2pm-4pm $10
 9E Horse Riding Age 8+ 9am - 1.15pm $20
 9F Rainbow Springs Rotorua Age 6+ (7 years and under need an adult) 8.15am - 3.30pm $29
 9M Before Care starts 8am $6
 9 After Care finishes 4pm $6
Wednesday 10th October
 10A Make Believe crafts & cooking Age 5+ 9.00am - 12.30pm $7
 10B Make Believe crafts & cooking Age 5+ 1.30pm - 3.00pm $7
 10C Action Fun and Games Age 7+ 9am - 12.30pm $4
 10T5 Tennis Age 5-7 years 1pm - 2pm $5
 10T8 Tennis Age 8-12 years 2pm - 4pm $10
 10E Pool Fun Age 7+ 1pm - 3pm $4
 10F Kids Market Age 6+ (7 years and under need an adult) 9am - 12noon no charge
 10M Before Care starts 8am $6
 10 After Care finishes 4pm $6
Thursday 11th October
 11A Fairy Tale crafts morning Age 5+ 9am - 12.30pm $7
 11B Fairy Tale crafts afternoon Age 5+ 1.30pm - 3.00pm $7
 11C Wrestling Age 7-13years 9am - 12.30pm $5
 11D King Seeds Age 7-11 years 1pm - 3pm $5
 11E Movie & Tenpin Bowling Age 9+ 8.30am - 3.15pm $27
 11M Before Care starts 8am $6
 11 After Care finishes 4pm $6
Friday 12th October
 12A Silly Spooky morning Age 5+ 9am - 12noon $7
 12B Party Time & Movie afternoon Age 5+ 12noon - 3pm $7
 12C Laser Tag & Hotpools Age 9+ 8.15am - 3.00pm $28
 12M Before Care starts 8am $6
 12 After Care finishes 4pm $6
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