After School Enrolment

(09) 521 0009 info@barfootstadium.co.nz

Home
About Us

Home
Upcoming Events
- NZ Grappler Regionals 2018
- GABBS Book Fair
Venue Hire
What's Here
- Futsal / Football
- Fitness and Health
Children's Activities
Gallery
About Us
Contact Us
New Page

Home
Upcoming Events
- NZ Grappler Regionals 2018
- GABBS Book Fair
Venue Hire
What's Here
- Futsal / Football
- Fitness and Health
Children's Activities
Gallery
About Us
Contact Us
New Page

(09) 521 0009

After School Enrolment

Please complete the following form for after school enrolment

* Indicates required field

Parent /Guardian Information

Full Name *

Address *

Phone (Daytime) *

Phone (Evening) *

Email *

Child's Information

Full Name *

D.O.B *

dd/mm/yyyy

Gender *

Male Female

Ethnicity *

Commencement Date *

dd/mm/yyyy

School Attended *

Classroom *

Teacher's name *

Days Required *

Monday Tuesday Wednesday Thursday Friday

Family Doctor *

Family Doctor Phone *

Health Record *

Please specify allergies and ailments (e.g. asthma, bee stings, food, penicillin and epilepsy), medical conditions, and assistance required.

Medication (to be provided by parent/guardian) *

Description of Medication *

Dosage *

Is this to be administered by the After School Programme Staff? *

Yes No

Is there any other information the Programme should be aware of? *

Emergency Contact 1

Full Name *

Address *

Phone (Daytime) *

Phone (Evening) *

Emergency Contact 2

Full Name *

Address *

Phone (Daytime) *

Phone (Evening) *

Other Authorised Adults to Pickup Children

Full Name *

Phone Number (Home) *

Phone Number (Work) *

Phone Number (Mobile) *

Relationship to Child *

Other Authorised Adults to Pickup Children

Full Name *

Phone Number (Home) *

Phone Number (Work) *

Phone Number (Mobile) *

Relationship to Child *

Terms and Agreement *

I have read the terms & agreement and acknowledge that ASB Stadium Staff will run the After-School Programme.

View "Terms and Agreement" for After School Programme

Submit

Barfoot & Thompson Stadium is a multi-purpose indoor facility that is conveniently located only 10km from the central city. With our flexibility and experience we can cater for large or small national and regional events as well as local community activities.

Contact

Phone
(09) 521 0009

Email
info@barfootstadium.co.nz

Address
203 Kohimarama Road, Kohimarama, Auckland 1071 (Selwyn College Grounds)

Events

Run & Gun Basketball Tournament
Saturday 7th to Sunday 8th July 2018

2018 Auckland International Open Judo Championship
Saturday 28th to Sunday 29th July 2018

NZ Grappler - GI Nationals
Saturday 11th August 2018

After School Enrolment

Parent /Guardian Information

Child's Information

Emergency Contact 1

Emergency Contact 2

Other Authorised Adults to Pickup Children

Other Authorised Adults to Pickup Children

Contact

Events

Quick Links