Inscription activités ado profil autiste

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Administration

Category and profile of participant

ADO - 13 à 21 ans

Person filling out the form

First Name of the person filling this form

Last Name of the person filling this form

Email

To which e-mail address should we send the service confirmation?

Person in charge of registration phone number

Participant information

First name

Last name

Date of birth

Informations du participant 2

Please complete this section if you are registering
1- other autistic children
and/or
2- siblings if you are applying for activities that are also opened to them.

Without this information, we will assume that the application only includes your child with autism and we will not have the resources to accommodate other children in the family.

First name (participant 2)

Date of birth (participant 2)

Informations du participant 3

First name (participant 3)

Date of birth (participant 3)

Informations du participant 4

First name (participant 4)

Date of birth (participant 4)

If one or more participants are 12 years old, please specify the type of school they attend (elementary or secondary).

If necessary, give us some details as per your answer.

I want to register for Day Respite offered on Saturday

Respite is offered

Schedule: Saturday from Noon to 4 pm
Frequency: 3 times during the session
Open to all teens aged 13–21, regardless of profiles without siblings.
Period of time: From January 21st to May 16th 2026
Cost : $15 per day

Saturday Teen Respite

Yes

No

I want to register for Teen Social Club offered on Friday

Teen Social Club is offered

To teens aged 15 to 19 who are autonomous and functional
Schedule: Friday from 6:30 to 8:30 pm
Frequency: every 2 weeks
Period of time: From January 21st to May 16th 2026
Cost : $10 per evening

Social Club

Yes

No

Please confirm the registration for the following activities by checking the appropriate box

Yes, I confirm the registration for March 5th.

March 5th - Outdoor Winter Activity
A parent may accompany their child and the equipment will be provided to them.
Not opened to neurotypical siblings.

Yes, I confirm the registration for March 28th.

March 28th - Afternoon for neurotypical siblings only.

Comment or additionnal information to share

Please indicate if necessary:

- Any dates when your child is unavailable.

- Any additional information you would like to share with the team.

Comment

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Registration