Register for ACT Programs
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Session Name
Session ID
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Session at Capacity?
Notice
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Session Information
Start Date
Time
Cost
(CAD)
All prices reflect the current prorated cost of the program.
Details
For children aged 13-15 | Saturdays @ 12:00pm-2:00pm | 6 Weeks | Nov 8, 15, 22, 29, Dec 6, 13
Location
Room
Child Information
Child's First Name
Child's Last Name
Birthdate
School Child Currently Attends
Does your participant have any medical conditions, allergies, or medications we should know about?
Yes
No
If yes, please specify below
Parent/Guardian Information
Parent/Guardian First Name
Parent/Guardian Last Name
Phone Number
Email Address
Address
Town/City
Postal Code
I would like to be added to the ACT Program email mailing list. (Optional)
Emergency Contact Information
Emergency Contact First Name
Emergency Contact Last Name
Emergency Contact Phone Number
Relationship to Child
Please select...
Parent/Guardian
Friend
Aunt
Uncle
Grandparent
View the photo/video consent terms
I have read and agree to the photo/video consent terms and
I grant MCRC permission to use photos of my participant on their social media accounts, website, and on promotional materials.
View the refund policy
I have read and agree to the refund policy
Payment Information
Total Amount Due:
Name on Card
Card Number
MM
YY
Code
Billing Email
Contact Information