Key Information:

A deposit of $40 per child required to secure booking (non-refundable).

Ages: 9-12 years

Prices:

One child: $135

Two Siblings:$250

Three Siblings: $350

Please pay a deposit of $40 per child online to:

Action Zone Camps, 38-9005-0758487-00 (please put camper name as reference)

No cash, credit cards or eftpos available on site - online banking only

NOTE: You will receive a confirmation email from us to confirm we have received your registration and deposit. If you do not hear from us please get in contact to confirm your child's placement in camp.

Registration Form

Name

First Name

Last Name

Age

Date of Birth

YYYY

Year at School

What year is your child at school?

Gender

Male

Female

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Emergency Contact 1

(Primary caregiver/parent)

Name

First Name

Last Name

Phone/cell

Emergency Contact 2

(must be avail 24/7 and not a primary caregiver/parent)

Name

First Name

Last Name

Phone/cell

Siblings coming to Camp

(please note they each need a separate form)

Dietary Requirements/Allergies/Behaviour Issues/Other Concerns

Please explain

ONE Cabin Buddy Request

School

No Contact with:

ARE THERE ANY PERSON(S) LEGALLY NOT ALLOWED ACCESS TO YOUR CHILD VIA PHONE OR VISIT DURING CAMP?

Payment Details

Internet Banking: Kiwi Bank 38-9005-0758487-00( please put camper name as reference) No cheques or credit available. No eftpos available on site-Cash only. A deposit of 50% of total fee required to secure booking. (non-refundable).

My Payment Method is by:

My Payment is for

(One Child, Two Siblings, Three Siblings) (Deposit only, Full Fee)

Feed Back

Tell us how you found out about camp….

Been to Action Zone before? We would love some testimonials for our website...so tell us about it!!

Photos

Photos of children permitted

Yes

Consent

I consent to all the information on this form being used for the purpose of running Action Zone. I agree that my child will abide by all camp rules. In the event of sickness or injury I authorise that qualified medical attention to be obtained and any expenses will be my responsibility. I give permission for my child to be in the care of the staff and leaders and they will be clear of any liability in the event of any injury or loss which the camper may experience to person or property.

I Agree

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