The Wisdom Project Registration Form
All workshops are FREE. Pre-registration is required. Sign up as one grandparent with one or more grandchild, or pairs of grandparents with a single grandchild. Open to grandparents ages 55+ and grandchildren ages 10+.


DAY & TIME: Sundays from 1:00 AM – 3:00 PM
LOCATION: The Assembly Hall (1 Colonel Samuel Smith Park Dr., Etobicoke, ON M8V 4B6)

CONTACT: Kim Dayman, Programs Manager | programs@lakeshorearts.ca | 416.201.7093

Email address
PROJECT WORKSHOPS AND DATES
Please indicate what date(s) you would like to enrol yourself and your grandchild for? Please check all that apply.
October 15, 2017
October 22, 2017
October 29, 2017
Storytelling and Creative Writing
November 12, 2017
November 19, 2017
November 26, 2017
Mixed Media Collages
January 21, 2018
January 28, 2018
February 4, 2018
Musical Expression
February 11, 2018
February 25, 2018
March 4, 2018
Dance and Movement
REGISTRANT'S INFORMATION
Grandparent Name 1 (First, Last)
Your answer
Date of Birth (DD/MM/YY)
You must be 55+ years of age.
MM
/
DD
/
YYYY
Grandparent Name 2 (First, Last)
You must be 55+ years of age.
Your answer
Date of Birth (DD/MM/YY)
MM
/
DD
/
YYYY
Grandchild(rens) Name(s) | First, Last
Sign up as one grandparent with one or more grandchild, or pairs of grandparents with a single grandchild.
Your answer
Date of Birth (DD/MM/YY)
The child/children must be 10+ years of age.
MM
/
DD
/
YYYY
CONTACT INFORMATION
Grandparent(s) Home Address (Include City, Postal Code)
Your answer
Grandchild(ren)'s Home Address (Include City, Postal Code)
Your answer
Primary Phone Number(s) Including Postal Code
Please include a primary home and/or cell phone number where you (the grandparent) can be contacted.
Your answer
OTHER PERMISSIONS AND INFORMATION
Dietary / Medical / Behavioural Restrictions and or Concerns
Please list any restrictions and/or concerns that are pertinent to your child, or if you would like to share any information with our staff that will aid and/or enhance your child's experience in our camp.
Your answer
Photography, Video and Media Consent
I the parent(s)/guardian(s) submitting this application give consent for any photographs, videos or testimonials of the applicant to be used in all Lakeshore Arts marketing/promotional materials including the Lakeshore Arts website, social media pages and channels as well as third party media providers such as community newspapers, local/national newspapers and television channels.
How and/or Where Did You Hear About Our Camp?
Your answer
Liability Waiver
While all reasonable measures and precautions will be taken to ensure the safety and good health of each participant, Lakeshore Arts and staff are hereby released from any and all liability in the event of injury, accident, illness, or misfortune that may occur to the participant and his or her property while in the care of Lakeshore Arts.
Required
I have read, understood the conditions of enrolment. I, the undersigned, the parent(s)/guardian(s) of the aforementioned, do hereby consent to his/her participation in the Lakeshore Arts PA Day Camp Program.
By entering your name and initials below you are effectively providing your signature, indicating that you understand, consent and agree to all the terms of enrolment and that all the information on this form is true and accurate, to the best of your knowledge.
Name and Initials
Your answer
THANK YOU FOR REGISTERING!!! WE WILL SEE YOU AT OUR WORKSHOPS!
Please complete the captcha before submitting the form.
Submit
Never submit passwords through Google Forms.
This form was created inside of Lakeshore Arts. Report Abuse - Terms of Service - Additional Terms