REGISTRATION FORM OUTREACH PROGRAMS – SPRING 2017

REGISTRATION BEGINS Sunday, January 29, 2017

Register in person: 12:00 noon – 2:00 p.m., Battle Centre

Please note:

We will accept registration forms IN PERSON or by mail only. No registration forms will be accepted before January 29, 2017

Please return your completed registration form along with payment (payable to Reena) to:

By mail or in person:

Jaime Marco, Supervisor Level 2, The Toby & Henry Battle Developmental Centre, 927 Clark Avenue West, Thornhill ON L4J 8G6

Participant’s Full Name:

Date of Birth (m/d/y): Gender: Maler Femaler

Street Address:

City: Postal Code:

Full Name of Parent(s) / Guardian:

Full Address (if different from that of Participant):

Phone Numbers: Home:

Work: (mother): (father):

Cell: (mother): (father):

E-mail Address(es):

Have you moved? Yes r No r Is this your first Reena program? Yes r No r

FOR AGES 16 & OLDER:
ARE YOU ON THE COMMUNITY NEEDS LIST IN: York Region o Toronto Region: o

Indicate / explain any allergies and/or changes in medication or behaviour of participant.

PLEASE ENSURE YOUR FAMILY MEMBER CARRIES EMERGENCY ID WHEN ATTENDING A PROGRAM

I / We give permission for my / our child / family member______to go on outings and travel by van / car during their attendance at the above programs. I / We hereby absolve REENA of any responsibility for any injuries that may occur on any outings. I / We give permission for my / our child / family member to be photographed for promotional purposes.
Parent/Guardian:______Witness:______
(print name & provide signature) (print name & provide signature)
Date: Date: ______

FOR FURTHER INFORMATION . . . PLEASE CALL Jaime Marco: (905) 889-2690 x 2224

SPRING PROGRAMS 2017

PLEASE NOTE: THERE ARE NO PROGRAMS FROM

APRIL 10 – 20, 2017 FOR PASSOVER; MAY 21 -22, 2017 FOR VICTORIA DAY

PROGRAMS

/ DATES / COSTS / ü /

TOTALS

SUNDAY FRIENDS CLUB NORTH
Battle Centre
927 Clark Ave. West
Age 3+
No program Apr. 16, May 21 /
Sunday
Mar. 26 – May 28
12 noon - 5 pm / (1:3 ratio) $392/8 weeks
(1:2 ratio) $504/8 weeks
(1:1 ratio) $616/8 weeks / r
r
r

ATHLETIC CLUB

Battle Centre
927 Clark Ave. West
Age 10+
No program Apr. 10 or 17, May 22 /
Mondays
Mar. 27 – May 29
6:00 – 8:00 p.m. / $250 / session
(7 weeks) / r

SWIM CLUB

Garnet William CC
501 Clark Ave. West
Age 7+
No program Apr. 11 or 18 /
Tuesdays
Mar. 28 – May 30
7:30 – 9:00 p.m. / $165 / session
(includes charge for pool) / r

LIFE SKILLS

Reena Community Residence
49 Lebovic Campus Way
Age 16-24
No program Apr. 12 or 19 /
Wednesday
Mar. 29 – May 24
6:30 – 8:30 p.m. / $200 / session
(7 weeks) / r

SOCIAL SKILLS GROUP

Battle Centre
927 Clark Ave. West
Age 7+
No program Apr. 13 or 20 /
Thursday
Mar. 30 – May 25
6:30 - 8:30 p.m. / $200 / session
(7 weeks) / r
SPECIAL OLYMPICS BASKETBALL
Battle Centre
927 Clark Ave. West
Age 16+
No program Apr. 13 or 20 /

Thursdays

Mar. 30 – May 25
6:30 - 8:30 p.m. / $110 / session
(7 weeks)
+
$20 for t-shirt / r

COOKING CLUB

Battle Centre

927 Clark Ave. West

Age 10+
No program Apr. 13 or 20 /

Thursdays

Mar. 30 – May 25
6:30 - 8:30 p.m. / $263 / session
(7 weeks) / r
PLEASE COMPLETE THE ATTACHED PAYMENT INFORMATION FORM
/ TOTAL COST: