SISG & TAO HOP - Registration Form
Event Timing: September 2018 - June 2019 - First Friday of each month. Our first social is on September 7 2018
John@spectruminsights.ca
613.220.5920
http://www.spectruminsights.ca/social-group.html

Spectrum Insights social Group (SISG) and The Art of Hanging Out Program (TAO HOP)
All potential applicants must have been previously interviewed or already attended a S.I event before registering. *
Required
Students Name: *
Your answer
Please note: Our programs are comprised of and best suited to students "classically" diagnosed with Aspergers or FASD, ADHD, PDD-NOS and a mild learning disability. That being said, we teach Social and Life skills to any student who wants to learn how to be more independent and make new friends. Students should be able to have reciprocal conversations, take direction handle transitions and able to self regulate. *
TAO HOP Registration - Sept 2018 to June 2019 - 3rd Saturday of the Month
S.I.S.G - Spectrum Insights Social Group - First Friday of each month starting Sept 7 2018 and ending June 7 2019
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.
Your answer
Parents Name(s)
Your answer
Date Of Birth
Your answer
Medical Concerns / Conditions
Your answer
Emergency Contact info: please include phone numbers! *
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. *
Required
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. *
Required
Dietary restrictions
I understand that a non refundable payment of $282.50 (or adjusted fee/Drop in fee) guarantees my child a spot at the social group. 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. Please consider the group and your child's interests, we are not able to offer refunds. Students with ASD can be changeable when it comes social groups, if you feel your child cannot commit to our social groups, then please reconsider joining as refunds are not given. Drops ins are encouraged in order to determine whether the group is a good fit for your child. We will do out best to encourage and motivate your child should he/she become anxious about attending. Our groups are meant to be fun, laid back and make social experiences a lot easier. *
Required
Payment is for Sept 2018 till June 2019. Drop in's are by invitation only. If paying after Sept 2018, fees will be adjusted. *
I will pay Via: *
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. *
Your answer
Would you like to stay updated via our newsletter? It is Gluten free and non GMO! *
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service