Jolly Jolly Arts & Reading Registration Form

Payments are currently accepted via e-transfer or cash in-person prior to the start date of the program. 

After completing the registration form, please email payment directions. If e-transfer, email the password and name used on the registration form. E-transfers can be made to If paying cash in person, email us to schedule an appointment. 

Registration spots will not be guaranteed until full payment is received. 

Programs must reach at least 3 participants to proceed. If a minimum number of students are not registered, a full refund will be given, using the same method of payment received. If a student is unable to make a class, a school credit will be issued.

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Email *
Student's Name *
First and last name
Full Program Name *
Date and Time of Program Attending  *
Student's Gender *
First and last name
Student's Date of Birth  *
Parent/Guardian Name(s) *
First and last name
Parent/Guardian Email *
Parent/Guardian Phone Number(s) *
Home Address *

A copy of the student’s immunization record is required. Are you able to provide us with a copy prior to your child's attendance to our centre?


Emergency Contact(s) and Number(s). Please write down the names, phone numbers, and relationship to the child of each contact.


I understand that in the event of an accident or illness occurring to my child, the Centre will make every attempt to contact me and/or another person on my child’s emergency contact list. If however, I or the person on the list cannot be reached, I hereby give Jolly Jolly Arts & Reading, its Directors and Employees authority to act on my behalf in case of emergency and to take appropriate steps to have a doctor attend to my child.

I also agree to release and indemnify Jolly Jolly Arts & Reading, its Directors and employees from any and all claims for damages arising from any injury or otherwise related actions to my child as a result of any accident, illness, injury or for any other reason arising from participation in any school activities.


I authorize my child to participate in photographic or video interviews for the use of Jolly Jolly Arts & Reading. I also authorize my child’s photographic images and/or video to be used by Jolly Jolly Arts & Reading for various forms of media to assist in publicity, promotional and marketing purposes  


Please specify any social, emotional or medical concerns that the Centre should be aware of (including any ALLERGIES):

How did you hear about Jolly Jolly Arts & Reading? (Select all that apply)

A copy of your responses will be emailed to the address you provided.
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