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2021 Jan Splash Break-Away Registration

Splash Break-Away is delivered by Drowning Prevention Auckland. This is a FREE holiday programme that is funded by Oranga Tamariki and delivered by Drowning Prevention Auckland.

For more information visit our websitehttps://www.watersafe.org.nz/community/holiday-programmes/
1. Please select the preferred week you would like your child to attend 
* Week Two programs are now FULL.  *This question is required.
Please select your preferred location:
*Papatoetoe Pool has reached capacity - we are no longer taking bookings for this pool
*Manurewa Pool has reached capacity - we are no longer taking bookings for this pool
*Parakai Springs & Hot Pools have reached capacity - we are no longer taking bookings for this pool
Please select your preferred location
*West Wave has reached capacity - we are no longer taking bookings for this pool
*Point Erin has reached capacity - we are no longer taking bookings for this pool
*Birkenhead Swimsation - has reached capacity - we are no longer taking bookings for this pool
*We are currently not taking any bookings for Mt Albert Pool 
2. Participant Information. *This question is required.
Gender
Ethnicity 
Age 
3. Copy of Emergency contact 1
This question requires a valid email address.
4. Emergency contact 2
This question requires a valid email address.
5. Parent/Caregiver Statement. (Please tick each box that applies to your child, or the child you are registering)  *This question is required.
8. Please select how you heard about this programme? 
10. Registrant details  *This question is required.
This question requires a valid date format of MM/DD/YYYY.
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