Summer Pop-Up Playground Registration
ANCC is excited to provide pop-up playgrounds for 2 hours on Tuesday and Thursdays starting on July 2nd!

Contact us at (226) 240-2332 or ashley@alisonneighbourhood.org
Sign in to Google to save your progress. Learn more
Email *
Before registration can begin we need to confirm a few items:
While Alison Neighbourhood (ANCC hereafter) will be making best reasonable efforts to reduce the risk of the spread of Coronavirus within its facilities, I acknowledge that the current Corona Virus pandemic in Ontario and Canada is ongoing, and agree that ANCC can in no way guarantee that my child or children that are receiving childcare pursuant to this agreement, or myself or any other authorized person entering ANCC premises to pick up or drop off such child will not become infected with the Corona Virus.
I am also aware that given the duration of our program (2hrs) washroom and water fountain facilities will not be available to my child and that it is understood that each participant must bring their own labeled sunscreen, hat, and water bottle.

Do you agree? *
Required
Parent/Guardian Name *
Email *
Phone Number *
Child's Name(s) and Age *
Which week will you attend? *
Required
Which 2nd week will you attend? (2 weeks maximum) *
Required
Emergency Contact Name: *
Emergency Contact Phone Number: *
Emergency Contact Name (2): *
Emergency Contact (2) Phone Number: *
I understand that my child and I will need to complete a pre-screening questionnaire and conduct a temperature check upon arrival. And I understand that failure to do so means my child will not be permitted to participate. *
Required
PHOTO RELEASE PERMISSION: I hereby give my permission to Alison Neighbourhood Community Centre and the Cambridge Neighbourhood Organizations for the unrestricted right to take, use and publish my photograph, video and likeness in publications, promotional materials, website and any other communication vehicles, including electronic forms, at its discretion. Further, ANCC/CNO shall have the exclusive right to make use of such photographs as it deems appropriate for purposes including, but not limited to, the promotion or illustration of its programs and activities. I release Alison Neighbourhood Community Centre and the Cambridge Neighbourhood Organizations and all of its directors, officers, employees, volunteers, and agents from liability claims and costs of whatever.
Clear selection
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Alison Neighbourhood Community Centre. Report Abuse