Site Based Weekend Respite Registration
If you would like to register more than one of your children, please fill out one form for each child. If you have not had services with Children's Autism Services of Edmonton within the past 6 months, please reach out to Breanne from our Intake Team at (780) 266-9827 to set up a profile with us first before you register. If you have any questions, please contact our respite team by email at respite@childrensautism.ca
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What are the initials of your child that you would like to register? *
What is your first and last name? *
What is the best phone number to reach you at? *
What is the best email to reach you at?
If you are selected for this round of site-based respite, you will be receiving ONE time slot out of those listed below for the period of October 9th-December 11th. Please check off all of the time slots below that would work within your schedule so that we can make a schedule that works for all families requesting this respite.
Again, this site-based respite will be held at our Maier Centre West!
What time slot(s) would work for you to receive this respite? *
Required
If you are selected for this exciting opportunity, our team will be reaching out to you by Wednesday October 6th at the latest. If you are not selected, we will also be letting you know by that time as well.
Thank you for your interest!
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