Power Zone Holiday Programme Registration

To register your child/ren for our July School Holiday Programme please complete the form below and click submit.

Child/ren's Details
Child #1 Name *
Child #1 Name
Date of Birth *
Date of Birth
Please select
Child #2 Name
Child #2 Name
Date of Birth
Date of Birth
Please select
Child #3 Name
Child #3 Name
Date of Birth
Date of Birth
Please select
Child #4 Name
Child #4 Name
Date of Birth
Date of Birth
Medical Information
If yes, please note child's name and provide description
If yes, please note child's name and provide description
If yes, please note child's name and provide description
Please enter number without spaces
Parental Information
Parent/Guardian/Caregiver #1 Name *
Parent/Guardian/Caregiver #1 Name
Please enter number without spaces
Please enter number without spaces
Home Address *
Home Address
Note: State or Province is NI
Parent/Guardian/Caregiver #2 Name
Parent/Guardian/Caregiver #2 Name
Please enter number without spaces
Please enter number without spaces
Emergency Contacts & Other
Emergency Contact Person #1 *
Emergency Contact Person #1
Please enter number without spaces
Emergency Contact Person #2
Emergency Contact Person #2
Please enter number without spaces
Other
Is there anyone else authorised to pick up your child? If yes please complete contact details
Other Name
Other Name
Please enter number without spaces
Restriction
Is there anyone forbidden by law to collect your child/ren? If yes please contact programme manager to discuss.
Consents
Consent #1 *
*I/We give consent for my child/ren to walk or bus home from the Holiday Programme
Consent #2 *
*I/We give consent for my child/ren to apply sunscreen when necessary
Consent #3 *
*I/We give consent for my child/ren to travel on transport organised by Powerzone for day trip activities.
Consent #4 *
*I/We give consent for my child/ren to be photographed for promotional purposes at any time, and maybe altered accordingly
Programme Bookings
Programme runs from July 10th - 14th 2017 from 8:30am - 3:30pm Bookings are available for: - 1 Day ($30 per day per child) - Full Week ($120 one child = 1 free day) - Full Week 2 or more children ($220 per week inclusive)
Daily Bookings
Please select days required:
Weekly Booking 1 Child
Please Select
Weekly Booking 2 or More Children
Please select
Terms & Conditions
Terms & Conditions *
Please carefully read the Terms & Conditions below and select SUBMIT to complete your registration. We will process your registration as soon as possible and issue and invoice that can be paid by internet banking or in person at the EIC Office Signing In: Powerzone will only be responsible for children signed in with time of arrival noted. Signing Out: Powerzone will not be responsible for children signed out with time of pickup noted. Late Parents/Caregivers will notify programme manager as soon as possible by 9.15am at the very latest, in an event that their child/ren will be late on any given day. Child/ren must be present onsite by 9.30am, the very latest. If child/ren arrive later than 9.30am, and we are no longer on site and are on route to our destination, parents/caregivers must then transport their child/ren to our location. If this is not possible, unfortunately we will not be able to provide care for your child/ren on that day. Cancellation: Parents/Caregivers will notify programme manager as soon as possible in an event that their child/ren will not be attending the programme on any given day. Please notify us by 9.00am the very latest - thank you. Sick: Parents/Caregivers will notify programme manager as soon as possible in an event that their child/ren is sick and therefore unable to attend the Holiday Programme. In an event that your child/ren become sick during the programme, we will notify parents/caregivers for pick up as soon as possible. Registration A full completed registration form is required in order for your child/ren to be accepted into the Holiday Programme: Caregivers must advise staff if there are any changes to the details listed on the enrolment form. Fee’s/Payments: Full payment must be made in order for your child to be accepted into the Holiday Programme. There will be no refunds if you decide to withdraw your child/ren from the Holiday Programme within 5 working days. There will be no refunds in an event that your child is absent on any given day due to sickness, or cancellation. Property: Powerzone will not be liable for any loss or damages to personal items brought to the Holiday Programme. Leaders will take necessary care. No money should be brought to the Holiday Programme. If any is lost, Powerzone is not responsible. General: Parents/Caregivers must provide adequate food and a named drink bottle for their child/ren. It is possible that the advertised programme may change without notice, due to unforeseen circumstances. Only suitable movies rated ‘G’ or ‘PG’ (Parental guidance recommended) may be shown to children. All PG movies will be previewed and approved by a staff member. Children are required to wear sunscreen and a hat in Term 1 and Term 4 school holiday breaks for outdoor activities. Parents/Caregivers acknowledge that this is a faith-based Holiday Programme where children will participate in prayer and worship.