Parent Permission Form | Download here

Kiwiana Tours Permission Form Updated Jan 2023

Parents, please fill in the following form to give permission for your child to travel with Kiwiana Tours  

Trip Name ___________________________________________________Trip Date_______________________

Student  Name (First) _____________________________(Last)________________________________________

Country__________________Student Email_________________________Student Mobile__________________

Gender ________________________________Date of Birth     ______/______/_______      (Min age 14years)

food, medical, emotional health, allergies,___________________________________________________

Emergency Contact________________________Name of School attending in NZ____________________________

Natural Parents contact Phone____________________Email______________________________________

 

Natural Parent Full Name_______________________________________________________________

I agree and give permission for my child to take part in travel programs that Kiwiana Tours offers & any of the following activities marked X                                                                                                                                      

Acknowledgment of Risk

I understand that there are risks associated while traveling and with other activity operators and these risks cannot be completely eliminated.

Kiwiana Risk assessment is available for your reading from our office. I know I can ask any questions from

Kiwiana Tours about the travel and activities my child may be involved in, to gain a better understanding of the risks involved.

I understand that Kiwiana Tours does not accept responsibility for loss or damage to personal property and that it is my responsibility

to check my own insurance policy. 

 

Natural Parent Signature _______________________________  Date signed _____/_____/______

 

Rotorua, Taupo & Waitomo Bay of Islands Coromandel All or other trips
White Water Rafting   Ocean Kayaking Ocean Kayaking Surfingguided (Summer
Bungy Jumping Swim with dolphins Bush walking Skiingboarding (Winter)
Zorb    Quad Bikes Sailing or boating  Horse Riding Horse Riding
Gondola & Luge Skydive Boogie Boarding  Rollers Skating
Boat (Jet Boat / Sail) Parasailing Surfing (not guided) Ice Skating
Skydive Helicopter   Zip lining
Black Water Rafting Paddle Boarding   Swimming in a  Lake 

    Spa   Pool

Any extreme Activity offered                             Tick any of the above for a South Island trip

 

Kiwiana Tours 2009 Limited | 42 Couldrey Cresent, Red Beach Auckland City 0932 New Zealand. 

www.kiwianatours.com | Tour Leaders PH Catherine 02102703611 | Dave 0272030403

Kiwiana Tours abide by the NZQA Code of Practice for the Pastoral Care of International Students and is Qualmark certified.  

This trip is run as a school trip and School rules apply, no drinking or smoking is permitted on this tour, even if you are 18 years or more. 

 

Student,  I have read all the above and agree to follow the rules and instructions of the Kiwiana tour leader while on tour. 

 

Student Signature:

 ________________________________________________________________________________