Date of Birth (format dd/mm/yyyy)
Health Card #
Name on Card
Does your child have any special physical or emotional needs we should be aware of?
Please Note: If you are paying with a credit card, please call 613-623-5938 with your card details after you complete and submit this form.
I choose payment option:
By submitting this registration you are acknowledging that you have read the ASD activity agenda, rules and regulations and that you and your family will abide by them.
I acknowledge that I have read the ASD activity agenda, rules and regulations and that I and my family will abide by them.
evolve theme by Theme4Press • Powered by WordPress