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Registration

4e à 6e année

Wednesday from 3:15 pm to 4:30 pm starting January 15th, 2025

Location : École St-Jean, 887, rue Principale Wickham (Québec) J0C 1S0
Total : $105.00 plus taxes
Number of Lessons : 8
Available Places : 22 / 22
Registration ends at : January 8th, 2025 at 11:59 pm

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Participant's first name :

Participant's last name :

Participant's gender :

Participant's date of birth :

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):

Following the activity, the participant …

Goes back home alone
Goes back to class
Goes back to daycare
Leaves with an adult

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