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AdaptAbilities Weekend Respite Programs Form
Home
Weekend Respite Programs Registration
Step
1
of
3
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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
We are currently accepting registrations for
Fall (September - December).
• Programs are all 11am - 4pm at minimum
• Program fees are non-refundable and are applied to all booked dates
• Cancellations must be received at
minimum 14 days notice to avoid hourly billing
• Spots are first come/first serve with all required documentation/fees paid
Cost
$5/day for McKernan Centre or Orange Hub
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)
Select Location
*
Ages 3 – 12 - McKernan Centre
Ages 3 – 12 - Orange Hub
Ages 13 – 17 - Head Office (Saturdays only) Please note: this program is not running - We are only collecting interest
Select Days
*
Saturdays
Sundays
Both
Saturdays
Select All
Sept 9
Sept 16
Sept 23
Sept 30
Oct 14
Oct 21
Oct 28
Nov 4
Nov 18
Nov 25
Dec 2
Dec 9
Dec 16
Hours
I require standard hours - 11:00 AM to 4:00 PM
I require before/after care (*hourly rates apply)
Before/After Care is only available Saturdays
Before & After Care
Before Care (10:00 - 11:00 am)
After Care (4:00 - 5:00 pm)
Drop Off Time
:
Hours
Minutes
AM
PM
AM/PM
Pick Up Time
:
Hours
Minutes
AM
PM
AM/PM
Sundays
Select All
Sept 10
Sept 17
Sept 24
Oct 1
Oct 15
Oct 22
Oct 29
Nov 5
Nov 12
Nov 19
Nov 26
Dec 3
Dec 10
Dec 17
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.