Parental Consent Form

Aroha Kids Holiday Programme

“Aroha Kids” Nature-based Kids School Holiday Programme at Kawai Purapura, 14 Mills Lane, Albany, Auckland. One form per child please.
How did you find out about our Programme?*
We’d love parents & caregivers to join us – what days and time would you be available?*
CHILD's DETAILS
Child's Name*
Child's Age*
Days your child is attending this programme:*
CHILD's HEALTH DETAILS
Does your child have any special dietary requirements, allergies, special conditions, disabilities, special needs or medication that we should be aware of?*
What pain/flu medication may your child be given if necessary?*
Family doctor’s name & phone number:*
PARENT / CAREGIVER’S DETAILS
Parent/Caregiver's Name*
Phone Number(s):*
E-mail:*
OTHER PEOPLE WHO MAY PICK UP YOUR CHILD
Name*
Any other instructions:
AQUATIC ACTIVITY CONSENT
Kawai Purapura has a shallow kiddies pool and also a large pool which is several metres deep at the deepest end. This is non-chlorinated; a healthier copper sulphate filtration system. We will be using these facilities during the programme.
I would like my child to take part in swimming in the pool activities*
- Yes
- No
Is your child water confident in a pool?*
- Yes
- No
Is your child confident in deep water?*
- Yes
- No
Does your child need to use a floatation device in the pool?*
- Yes
- No
PERMISSIONS
I have received sufficient information about the event and agree to my child taking part in the LiAroha Kids Programme activities:*
- Yes
- No
I confirm that my child is in good health and I consider him/her fit to participate:*
- Yes
- No
I give permission for sun block / insect repellant to be applied to my child:*
- Yes
- No
I give permission for photos of my child to be used in Kawai Purapura marketing (ie: Facebook, website)*
- Yes
- No
I have read and I accept the Aroha Kids Terms & Conditions / Guidelines (included at the end of this form)*
- Yes
- No
Name of Parent/Caregiver*
Date*
Terms and Conditions
AROHA KIDS AT KAWAI PURAPURA TERMS AND CONDITIONS
TO BE READ AND SIGNED BY ADULT ASSISTANT OR PARENT/CAREGIVER OF EACH CHILD PARTICIPANT.

Parental Consent
I agree to my child/myself taking part in the Kawai Purapura “Aroha Kids” School Holiday Programme and I have received sufficient information on which to base a decision. I agree to their/my participation in the activities described. I acknowledge the need for them/me to behave responsibly. I confirm that my child is aged 5-12 years.

Acknowledgement of Risk I have read the event information sheet and I understand that there are risks associated with involvement in Kawai Purapura “Aroha Kids” Kids School Holiday Programme and that these risks cannot be completely eliminated. I understand that the school will identify any foreseeable risks or hazards and implement correct management procedures to eliminate, isolate or minimise those hazards. I understand my child has been involved in the development of safety procedures. I will do my best to ensure that I/my child follow these procedures.

I know that I am able to ask any questions of the Kawai Purapura “Aroha Kids” School Holiday Programme about the activities I/my child will be involved in, to gain a better understanding of the risks involved. I recognise that participation in such activities is voluntary and not mandatory through a ‘challenge by choice’* procedure. My child and I both understand that I/they may withdraw from an activity if I/they feel at risk. This must be done in consultation with the person in charge.

In understand that Kawai Purapura does not accept responsibility for loss or damage to personal property and that it is my responsibility to check my own insurance policy.

NOTE: At Aroha Kids we believe in connecting kids with Nature, and at times this involves getting just a little bit muddy with perhaps the odd small bruise or scrapes that occurs with discovering their adventurous side. We will always keep your children within safe parameters ensuring that no real harm comes to them, but genuinely trust that to grow strong in mind, body, and character, even children must be provided with the freedom to fall and pick themselves up again.

We urge that all parents equip their children with good wet weather gear for those rainy days that may come out the blue. Our programme will carry on during all weather conditions unless there are severe weather warnings because at Aroha Kids we understand that life can throw a curve ball at us at any given time, providing us with the opportunity to turn a rainy dreary day into a day of excitement and a new perspective to play with.

Refund Policy There is no refund if you cancel within 2 days prior to the programme starting. If the programme is cancelled for any reason, you will receive a full refund directly back into your bank account or credit card (minus the small fee that Eventbrite deducts from each ticket sale). We will do our best to inform you in good time of any cancellation. * ‘challenge by choice’ means the participant chooses their own level of challenge within a supportive peer environment.

KAWAI PURAPURA GUIDELINES The Land of Kawai Purapura We live on a sacred place where we transform the way we relate with the land, each other and the planet. This is a no drugs, alcohol and non-smoking environment. Thank you for respecting this policy. All of the Aroha Kids Programme activities will be held outside on the grass of The Plains, in the native bush and outside in the large Plains Marquee. If the weather does not permit this, we will use an inside venue: Lotus Sanctuary.

Activity times Please respect activity times during the programme, as this will keep the flow of all activities.

How to get to Kawai Purapura We are located on the North Shore: 14 Mills Lane, Albany (directly opposite Mitre 10 Mega on Oteha Valley Road). Just 20 minutes from the Auckland City Centre. Northern Busway buses travel between the Station and Britomart (Auckland CBD), departing approx every 10 minutes. The Albany bus station is a 10-minute walk from Kawai Purapura. PARKING You may park your car at Kawai Purapura while picking up and dropping off your child at the Aroha Kids Programme. Please follow the signs to the public parking area down the driveway by the Lotus Sanctuary. We will be situated in the large outdoors Plains Marquee beside the parking area - or in Lotus if it’s cold/raining hard. Alternative parking is in the Council Carpark (Hooten Reserve) at the bottom of the drive. From there it is an enjoyable 3 minute nature walk up the drive.

Residential Community In addition to being a Retreat Centre, Kawai Purapura also is a residential village, with around 90 residents. During the programme the residential community (full-time residents) will also be sharing some of the toilet and shower facilities. Come and Play We are a Retreat and Holistic Living Centre where like-minded people meet and live on a stunning 19-acre property of New Zealand bush and stream. Bring your togs and feel free to have a dip in our 25-metre swimming pool or in the spa pool while you are here. This pool is non-chlorinated; a healthier copper sulphate filtration system. Please be aware that occassionally the copper sulphate can turn hair green. Please ensure you / your child wears a bathing cap while in the pool if you’re concerned about this.

Newsletter If you would like receive our monthly email newsletter to find out more about us and what’s happening here, you can subscribe to our Newsletter database at www.kawaipurapura.co.nz Privacy and Spam Policy Kawai Purapura does not rent or sell email lists to anyone for any reason whatsoever without your agreement. You will never receive unsolicited email as a result of subscribing to our monthly newsletter. You can unsubscribe at any time by using the link on any edition of the newsletter.
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For any enquiries please contact: Cherish Co-ordinator Aroha Kids - Connecting kids with nature Kawai Purapura Retreat Centre - Nature's Playground 14 Mills Lane, Albany, North Shore, Auckland 0632, NZ Phone: (09) 415 9468. Mobile: (022) 312 5116 Email: arohakids@kawaipurapura.co.nz www.kawaipurapura.co.nz/school-holiday-programme/
By checking this box you agree to the terms and conditions above*
- I agree

Parental Consent Form

Parental Consent Form

“Aroha Kids” Nature-based Kids School Holiday Programme at Kawai Purapura, 14 Mills Lane, Albany, Auckland. One form per child please.

CHILD's DETAILS

CHILD's HEALTH DETAILS

PARENT / CAREGIVER’S DETAILS

OTHER PEOPLE WHO MAY PICK UP YOUR CHILD

AQUATIC ACTIVITY CONSENT

PERMISSIONS

Terms and Conditions