Family Sign Up

Family Registration

If your family is interested in signing up for "A RIPPLE EFFECT" , please fill this basic form. Our intake department will contact you to meet with your family in person. We also have additional forms with more detailed family information (health & medical information, liability waivers, etc.) . Once that is all completed, and the program is a good fit for your family, you can sign up for volunteers for your child, and all of our additional programming. We look forward to meeting you!

Health Forms & Full registration

Please print the PDF below and return to our office. You may submit it by mail or email. Email: Arippleeffectottawa@gmail.com
Mail: A Ripple Effect 23 Palisade Street, Ottawa, Ontario K2G 5M6.

family_registration_form_a_ripple_effect__1_.pdf
File Size:	409 kb
File Type:	pdf

Download File

Please fill in this Basic Registration

* Indicates required field

Name of Mother *

MOM'S Phone Number *

Name of Father *

Phone Number *

Email *

Address *

Line 1

Line 2

City

State

Zip Code

Country

Name/s of your children (please include gender & age) *

I am the *

Religious Affiliation *

How did you find out about A RIPPLE EFFECT? *

Brief Medical History (all information is confidential) *

Programs we are interested in: *

Any questions? Comments? *

Submit

* Please follow up with our office at 613-618-3843 if you have any questions or to request a meeting with our intake department. Thank you!

Family Sign-Up

Family Registration

Health Forms & Full registration

Please fill in this Basic Registration