North Bay Learner Registration Form
We currently are accepting new registrations for our virtual Creative Writing and Number Ninjas programs. Registration is limited - please complete the below registration form and we will be in touch with the next steps. Contact northbay@unitedforliteracy.ca if you have any questions. Thanks!
Please complete all the fields on this form. The more information you provide, the more prepared we will be to accommodate your child.
Child's Name:
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First Name
Last Name
Current Grade:
Age:
*
Current or School Last Attended:
Is your child taking part in Learning At Home this year and not attending school in person?
Please select
Yes
No
Yes or No
Parent/Guardian Information
Parent's full name:
*
Email address:
*
Telephone:
*
Address:
*
Street Address
Street Address Line 2
City
Province
Postal Code
Program Selection
What program would you like to register your child for? Note that all programs are Zoom-based, and require access to a laptop, tablet, computer or smartphone, as well as internet access. Please select all programs that you are interested in. Thanks!
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Virtual Number Ninjas (Grades 3-5; Tuesdays, 5-6pm; Jan. 31 - April 4, 2023
Virtual Creative Writing Club (Grades 4-6; Thursdays, 5-6pm; Feb. 2nd - April 6, 2023)
Why you would like to register your child for the above program? Are there specific skills that you would like your child to work on?
Please share what hobbies or interests your child has, as well as some of their favourite subjects or books:
Has your child ever taken part in a United for Literacy (formerly Frontier College) program before?
Yes
No
I agree to my child using VIDEO during their tutoring session.
*
Yes
No
I agree that my contact information (email and phone) can be shared my child's tutor so they can schedule sessions.
*
Yes
No
I agree to be contacted by United for Literacy (formerly Frontier College) to confirm my child's registration and my contact details.
*
Yes
No
I would like to be present online (note that this option can be changed at a later date by contacting the United for Literacy (formerly Frontier College) Community Coordinator):
*
At the start of each tutoring session
At the start of the first tutoring session
Throughout every session
Whenever I can
Other
I understand that United for Literacy may ask my child about their goals, and about the progress they have made. I also agree that United for Literacy may ask questions to assess my child’s skills in reading, writing and math at the beginning and end of the program. I understand that my child can choose not to answer any assessment question, and that all information collected from my child will be kept private.
*
Yes
No
I ALLOW United for Literacy staff and volunteers to collect writing samples, video, photographs or written feedback from my child during the United for Literacy program. I understand these images and/or recordings may be used for any and all reasonable purposes including print publication, broadcasting, electronic and digital transmission, transmission on social media, duplication, distribution, and stock footage as determined by United for Literacy. My child's full name WILL NOT be included with any image or recording. I understand that the images and/or recordings may appear in electronic form on the internet or in other publications outside United for Literacy's control. I will not hold United for Literacy responsible for any harm that may arise from such unauthorized reproduction.
Yes
No
I confirm that I am the PARENT/LEGAL GUARDIAN of this child and allow United for Literacy to provide them with tutoring or instruction online. I understand that there is no cost for the United for Literacy program, but that registration is based on available tutors, and cannot be guaranteed. If I decide to withdraw my child's registration, I agree to contact United for Literacy North Bay so that my child's tutor can be matched with another learner. I also understand that I may be asked to provide feedback on the program through email or with an online survey.
*
Yes
No
Submit Registration
Should be Empty: