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Login
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Our Story
Impact
Annual Reports
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Work With Us
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Get Involved
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Wish List
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Breakfast
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AdaptAbilities Community Connect Form
Home
Community Connect Registration
Step
1
of
3
33%
New & Returning Participants
Participants that have not previously attended programming at AdaptAbilities must complete an intake prior to completing this registration form.
I have received services from AdaptAbilities before OR completed the intake process
*
Yes
No
Community Connect
Monday – Friday 9 AM– 3 PM
I have a current funding agreement
*
PDD
FSCD
No Funding Agreement
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
Millbourne Market Mall
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
Sorry! You cannot continue registration.
Hi there! If you are new to AdaptAbilities, you must complete an intake prior to registering for programming.
To book an intake, please call our office at 780-431-8446 or submit a service request
here.
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