Just For Girls Social Group - Registration Form
Event Timing: September 2018 - June 2019 - 2nd Friday of each month. Our first social is on September 14 2018

Students Name: *
Your answer
All potential applicants must have been previously interviewed or already attended a S.I event before registering. *
Parents Name(s) *
Your answer
Date Of Birth *
Your answer
Medical Concerns / Conditions *
Your answer
Emergency Contact info *
Your answer
Individuals Authorized to Pick up / Drop Off *
Your answer
Photo Permission - Any photos/videos taken may be used to help promote and document the activities of Spectrum Insights events through our website, Facebook, Twitter and Instagram. Names and personal information of the students WILL NOT be used. *
Special Diet *
Waiver: It is my understanding that an activity of this nature has inherent risks involved. All reasonable precautions for the safety and health of the participant will be taken. He/she will be properly supervised in activities. In the event of accident or sickness, Spectrum Insights, sunnyside Weslyan Church, its staff and volunteers are released from any liability. In the event of injury requiring medical attention, I authorize treatment for the participant and understand that reasonable attempts will be made to contact me, should such a situation occur.Please note this group is not appropriate for any aggressive behaviours or students that may potentially run off. Students must be able to exhibit independence and ability to follow complex group instruction. *
I understand that I will have to pay $250 in Order to register my Daughter
Payment can be made to John Anderson Via: *
Payment options:
Electronic Fund Transfer: John@spectruminsights.ca
Cheque made payable to: John Anderson 316 Robillard Pvt Ottawa ON K1T2V8
I will pay Via: *
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