Enrolment Form

All parents must complete an online enrolment form before their child can attend The Pod. This only has to be done once, and once submitted you can book your child into any of our holiday programmes.

Number of children you’d like to enrol? *

• One
• Two
• Three

When would you like your child to attend The Pod? *

• Before School
• After School
• Holiday Programme

Childs Information

Childs First Name *

Childs Surname *

Date of Birth *

What school does your child attend? *

Does your child have any particular health needs we should be aware of? (i.e. allergies, food requirements, asthma, or medical conditions)

• No
• Yes

Please list all health needs here

Is there any further information regarding your child that would help our team better care for your child? (i.e. special needs or behavioural support)

• No
• Yes

Please list any further information you think may help us here

Are there any custodial arrangements regarding your child?

• No
• Yes

Please list any further information you think may help us here

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Second Childs Information

Second Childs First Name *

Second Childs Surname *

Second Childs Date of Birth *

What school does your second child attend? *

Does your second child have any particular health needs we should be aware of? (i.e. allergies, food requirements, asthma, or medical conditions)

• No
• Yes

Please list all health needs here

Is there any further information regarding your second child that would help our team better care for your child? (i.e. special needs or behavioural support)

• No
• Yes

Please list any further information you think may help us here

Are there any custodial arrangements regarding your second child?

• No
• Yes

Please list any further information you think may help us here

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Third Childs Information

Third Childs First Name *

Third Childs Surame *

Third Childs Date of Birth *

What school does your third child attend? *

Does your third child have any particular health needs we should be aware of? (i.e. allergies, food requirements, asthma, or medical conditions)

• No
• Yes

Please list all health needs here

Is there any further information regarding your third child that would help our team better care for your child? (i.e. special needs or behavioural support)

• No
• Yes

Please list any further information you think may help us here

Are there any custodial arrangements regarding your third child?

• No
• Yes

Please list any further information you think may help us here

Parents Information

Parents name *

Relationship to child *

Email *

Address *

Phone: Mobile *

Phone: Work *

Parents name 2 *

Relationship to child *

Email *

Address *

Phone: Mobile *

Phone: Work *

Please list any people NOT authorised to pick up your child (if any)

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Emergency Contact Information

For civil defense purposes, we encourage one emergency contact to be located outside of the South Wairarapa region.

Emergency Contact 1 *

Phone: Mobile *

Relationship to child *

Phone: Work

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Emergency Contact 2 *

Phone: Mobile *

Relationship to child *

Phone: Work

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Checkboxes

• By clicking here you acknowledge that you have read and agreed to The Pod’s policies.

Submit