Registration

National - Semaine 6 du 28 juillet au 1 août 2025

Monday from 8:30 am to 1:30 pm, Tuesday from 8:30 am to 12:30 pm, Tuesday from 2:00 pm to 4:00 pm, Wednesday from 8:30 am to 12:30 pm, Thursday from 8:30 am to 12:30 pm, Thursday from 2:00 pm to 4:00 pm and Friday from 8:30 am to 1:00 pm starting July 28th, 2025

Location : National, 3600 1re rue, Saint-Hubert
Number of Lessons : 7
Registration ends at : September 1st, 2025 at 8:00 am

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Participant no. Remove

Participant's first name :

Participant's last name :

Participant's gender :

Participant's date of birth :

Full name of person to contact in case of emergency (if parents cannot be reached) :

Telephone of the person to contact in case of emergency (if the parents are not reached) :

I authorize the transport of this child by the persons in charge assigned to the transport :

This child needs a car seat for transportation :

Health Insurance number :

Health Insurance Card Expiry :

Particular health conditions of the participant :

ADD
ADHD
ASD
Asperger syndrome
Asthma
Behavioural disorder
Breathing problem
Cardiac malformation
Cystic fibrosis
Diabetes
Dysphasia
Dyspraxia
Egg allergy
Epilepsy
Fish allergy
Food allergy
Hypoglycemia
Kiwi allergy
Language disorder
Latex allergy
Myopathy
Nephrotic syndrome
Peanut or nut allergy
Penicillin allergy
Seafood allergy
Tourette syndrome
Trisomy (adult required)
Visual impairment
Others (if applicable):

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Registration

National - Semaine 6 du 28 juillet au 1 août 2025

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