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Special Needs Entry
1:1 Buddy Registration
Primary Contact Information
Campus
Airdrie
Bearspaw
Bridgeland
Central
Online
South
Core
Campus is required.
First Name
First Name cannot contain special characters such as quotes, parentheses, etc.
First Name cannot contain emojis or special fonts.
First Name is required.
Last Name
Last Name cannot contain special characters such as quotes, parentheses, etc.
Last Name cannot contain emojis or special fonts.
Last Name is required.
First Name of Participant
First Name of Participant is required.
Last Name of Participant
Last Name of Participant is required.
Relationship to Participant
Relationship to Participant is required.
Phone Number
Phone Number is required.
Email
Email address is not valid
Email is required.
My child or loved one has the following medical diagnosis, learning difficulty or special need (please include severity):
My child or loved one has the following medical diagnosis, learning difficulty or special need (please include severity): is required.
My child or loved one needs assistance with:
My child or loved one needs assistance with: is required.
My child or loved one's strengths and interests include:
My child or loved one's strengths and interests include: is required.
My child or loved one’s behaviour may require attention when:
My child or loved one’s behaviour may require attention when: is required.
My child's age is
My child's age is is required.
The Service we attend is:
4:30 PM
6:30 PM
9:00 AM
11:00 AM
The Service we attend is: is required.
The Campus we attend is:
Central
Bearspaw
Bridgeland
South
Airdrie
The Campus we attend is: is required.
Submit