Lanark Highlands Youth Centre after School Program

The Lanark highlands youth centre will be offering a new after school program, to be held at Maple Grove Public school as of January 18 2013. This school based program will focus on supporting Physical activity, healthy food choices, nutrition and education as well as personal health education. We will be offering various workshops which will involve guest speakers from various community and government groups (e.g. Home and work safety, drug abuse prevention, Bullying, Career workshops) every day we will offer different topics and fun activities as well as a healthy after school snack. The program will be running form 3:30pm -6:00pm Monday to Friday night. This program will be open to youth ages 10 and up and there is NO cost to register for this program. This is NOT a drop in program, therefore we ask for you to fill out the fallowing information and return it to Youth Centre staff or Maple Group Public School staff as you MUST register your child/youth. If you require any further information or have any questions, Please feel free to contact Youth Centre staff at any time. 613 259-2012 or lhyci@storm.net

__________ Participants name: Participants date of Birth: Home address:_________________________________________________ Health card number: Emergency contact name and number: Allergies / other information: Parents name and contact number: Name of parent who will be picking youth up:_______________________