Simply click the button below to complete our online referral and registration form.

This form is to be completed for each young person participating in
Pearanui Trust activities by parents/caregivers or entities with youth in their care.
This gathered information is confidential and will be treated accordingly.
We understand the importance of maintaining the privacy and confidentiality
of the youth and their personal information.
We will handle all information provided in this referral form with the
utmost care and respect for privacy.