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DONATE
Register
Parent Resources
Blog
Login
About
Impact
Services
Team
Careers
Contact
get involved
Volunteer
Wish List
Other Ways to Give
HOPE Campaign
DONATE
AdaptAbilities Community Connect Form
Home
Community Connect Registration
Community Connect
Monday – Friday 9 AM– 3 PM
I have a current funding agreement
*
PDD
FSCD
No Funding Agreement
I have received services from AdaptAbilities before
*
Yes
No
Parent/Guardian Name
*
First
Last
Phone Number
*
Email Address
*
Participant Name
*
First
Last
Participant Date of Birth
*
(dd/mm/yyyy)
DD slash MM slash YYYY
Age
(calculated automatically)
Location
*
McKernan Respite Centre
Orange Hub
Hours
*
I require standard hours - 9:00 AM to 3:00 PM
I require before/after care (*hourly rates apply)
Before & After Care
Before Care (7:30 AM - 9:00 AM)
After Care (3:00 PM - 6:00 PM)
Drop Off Time
:
Hours
Minutes
AM
PM
AM/PM
Pick Up Time
:
Hours
Minutes
AM
PM
AM/PM
