Waitlist Holiday Programme

Parent/Caregiver First & Last Name*

Child/ren Name(s)*

Email*

Phone*

Choose a Centre*

Adventure School

Waterloo School

Number of Children to Enrol*

1

2

3

4

5

6

Will you be applying for a WINZ subsidy?*

Yes

No

Please select days/types of care you require*

Monday Before School Care

Tuesday Before School Care

Wednesday Before School Care

Thursday Before School Care

Friday Before School Care

Monday After School Care

Tuesday After School Care

Wednesday After School Care

Thursday After School Care

Friday After School Care

Please specify your STARTING DAY*

Any other information can be written here

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