Parent/Guardian's Name *

First Name

Last Name

Child's Name *

First Name

Last Name

Participant Cancellation Policy *

If you cancel your registration before June 25 (2-weeks before the group start), you will receive a full refund. If you cancel your registration after June 25, you may not receive a 50% refund.

I acknowledge and agree to the participant cancellation policy

SYC Cancellation Policy *

If, for any reason, SYC needs to cancel this group, you will receive a full refund.

I acknowledge SYC's cancellation policy

Payment ($240+HST) *

Payment is required at time of registration. Please note participation in this group may be covered under some insurance plans.

I would like to speak to someone about financial assistance.

I will e-transfer payment to payments@soundyouthcounselling.ca

I would like to pay another way (credit card, cheque or cash). Please contact me.