Name: Nature Academy (Spring 2022)
Start: 2022-04-18T00:00:00-04:00
End: 2022-06-24T23:59:59-04:00
Location: Cedar Haven Eco-Centre

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Nature Academy (Spring 2022)

April 18, 2022 - June 24, 2022

| $550

An outdoor school for hands-on science, wilderness skills, gardening, and child-led nature exploration. Learn more.

Payment & Registration

After purchasing your Eventbrite ticket(s), please make sure to also fill out the registration form.

*If you are registering more than one child, click the blue “Enter promo code” button at the top of the tickets page and enter FAM10 for a 10% discount on your order! (If you are having trouble finding it, feel free to email us at nature.academy@arocha.ca for support before paying as we are unable to provide refunds regarding this after payment is complete.)

REGISTRATION FORM

Nature Academy Registration

Student Information

General Information

First Name

Last Name

Date of Birth

Age

Home Address

Please upload a picture of the student so we can get to know them before they arrive!

*This photo will not be used in any A Rocha marketing or media.

Medical Information

OHIP Number

Family Doctor

Family Doctor Phone Number

Does your child have any Health Concerns? (Social, emotional, physical, medical, behavioural, developmental, or otherwise?) Please explain. Any information will help us to support your child.

Does your child have any Allergies? Please explain.

Does your child carry an Epipen?

YesNo

Does your child have any dietary restrictions? Please list them below.

Nature Academy Class

Each class considers the learning level and abilities at each age, and follows a curriculum aligned with the Ontario Curriculum learning objectives for that grade.

What class will the student be joining?

Please refer to your Eventbrite email confirmation to ensure that you choose the correct class group.

If you are registering a student in a class outside of their age range or grade level, please indicate why:

Media Consent

I hereby grant A Rocha Canada (ARC) the absolute right and permission to use, re-use and distribute, without financial consideration, photographs, video and/or audio of my child (named above) in any and all media, in perpetuity. I also consent to the use by ARC of my child's (named above) personal story for use in any media.

YesNo

Parent/Guardian Name (First and Last)

This will act as an electronic signature, confirming that you have
read and agree to the terms above.

Date

Liability Waiver

The Nature Academy promotes "hands-on" education. While every program activity is appropriately designed for each age group, and carefully taught and supervised by our staff, there are risks involved. A Rocha Canada and Staff will not be held liable for any injury sustained during program activities.

By submitting your name below, you as the parent or legal guardian of the child registered, acknowledge the possible risks, dangers and hazards associated with participation in the activities, and allow for your child to participate in all activities related to the Nature Academy program.

Parent/Guardian Name (First and Last)

This will act as an electronic signature, confirming that you have
read and agree to the terms above.

Date

Registering another Student?

If you are registering more than one student in the same family, they must share the same Family Information below, including Primary Parent/Guardian; Second Parent/Guardian or Emergency Contact; and Carpooling details. Additionally, all students registered on this form must be paid for together.

Family Information

Primary Parent/Guardian

First and Last Name

Relation to the Student

Phone Number

Secondary Phone Number

This email will receive all Nature Academy communication
and important program announcements.

Yes, I want hopeful creation care news in my inbox every month!

Home Address

Second Parent/Guardian or Emergency Contact

In case of emergency, where the Primary Parent/Guardian cannot be reached, this person will be contacted.

First and Last Name

Relation to the Student

Phone Number

Secondary Phone Number

This email will receive all Nature Academy communication
and important program announcements.

Yes, I want hopeful creation care news in my inbox every month!

Carpooling?

Please list the names (First and Last) of any adults not mentioned above who are allowed to pick up your child(ren) after class.

Confirmation

By submitting your name (first and last) below — as an electronic signature — you, as the parent or legal guardian of the child(ren) being registered, confirm that the information above is accurate.

Contact Information

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