PGNG L.I.T. Summer Program Participant Information Form

Welcome to our summer programming for 2020! While we running programs with the same spirit as previous summers, there are going to be a few procedural and policy changes. Please fill out this form for all of the youth attending our program. Please be aware that all in person programs will be limited to 10 persons (including 2 staff) per week, therefore, each program will have a maximum of 8 participants per week. To minimize the spread of COVID 19, we are asking participants to be flexible with program availability. We will

If you have any questions, comments, or concerns, please do not hesitate to reach out to us by phone at 519 824 6340 or by email at
Parent/Guardian's name and email address *
Please write your home address *
Parent/Guardian's Phone Number *
Please provide an emergency contact name and phone number. Please ensure this person is available for immediate pick up in case program is closed. *
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