Moving Forward - Registration Form - You can skip the contact details if there are no current changes. If this is your first time attending, please fill out the following questions.
All potential applicants must have been previously interviewed or already attended a S.I event before registering.
My child has been interviewed by the director
My Child already attends a Spectrum Insights program or coaching
I would like to be interviewed. Please see the additional comment section at the bottom of this form.
MF socials - 4th Saturday of each month - 3 hours - Activity fees will be extra. $250 for 10 socials - Sept to June. Limited to 8 students! We are not offering drop in availability.
Please sign me up! Payment options below.
You can skip the contact details if there are no current changes. If this is your first time attending, please fill out the following questions.
Date Of Birth
Medical Concerns / Conditions/allergies
Emergency Contact info - please include Phone numbers
Individuals Authorized to Pick up / Drop Off
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.
Yes I give permission for my child to be photographed
No I do not give permission for my child to be photographed
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 and agree
We will not be reimbursing for missed days. Should there be a scheduling error on our part where a monthly social is cancelled and not rescheduled later in the month, we will reimburse the cost of the night missed.
I understand and agree
Payment secures a spot for your child. Options below:
$250 Cheque to: John Anderson 316 Robillard Pvt Ottawa ON K1T2V8
$250 Electronic Fund Transfer to:
By typing my name below, I confirm that I have read and understood the Registration Form. I also confirm that the information I have provided on this form is true, correct, and complete.
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