Kidzacool Referral - One or First Child Logo

  • KidzaCool Adventures - One or First Child Application

  • Child and Caregiver Details

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  • Details of all people living at child’s address

    Please include other children and note if the person is a Legal Guardian
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  • Other Significant People NOT living with the child

    Please include other children but exclude service providers
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  • If the legal guardian does not live at the child’s address, please provide the contact details of all legal guardians as we are required to advise all legal guardians of our service involvement with the child.

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  • Behaviour and Health Checklist - Part 1

    Full disclosure of the following behaviours is required to enable an accurate assessment of the level of support your child may need and to ensure we can provide a safe environment for all the children attending the programme.

  • Behaviour and Health Checklist - Part 2

  • Health Information


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  • Community Services Card Details

    This is required should the child need medical care/prescriptions while at the village.
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  • General Information

  • Visiting Information

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  • Consent Form

  • I/we give consent for Stand Tū Māia to:

  • Special Activities: I give permission for my/our tamariki mokopuna (child) to participate in the following:

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  • Please click PREVIEW to check your form and SUBMIT only when you have completed the form - you will not be able to edit it once it has been submitted.

     

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