Fall-Winter Term Programs Registration Form
This Tutoring term is currently full! Please call or email us to be put on the waitlist for tutoring! Scroll down to fill out the section of the form on the B.E.S.T. social skills program if you would like to join this group!
Street Address Line 2
First and last names of one or both guardians
Please enter a valid phone number
Any serious allergies or medical information we should know about?
Social Skills: B.E.S.T. Program (Fill out this section only if interested in our BEST program):
BEST is currently offered to an older age group of students aged 9 to 13 (A younger group of social skills will be offered in March). This program assists participants in the development of social skills and social problem-solving strategies so that they can interact successfully with others and cope effectively. This program will start on October 13th, and run for a 10 week duration until December 15th. We will meet on Wednesdays at 5:15pm to 6:15pm. The cost is $100 for members and $110 for non-members. A deposit of $45 is required at the time of registration, and the membership fee is $50 (optional). BEST will run in person in Chatham, however, in case of a lock down we will move this program online using Zoom.
Are you interested in registering for our social skills program?
Is your child between the ages of 9-13?
Select your child's top 5 problem areas:
Accepting Consequences/Accepting 'No'
Anxiety-Signs and Symptoms
Body Language/Body Cues
Bullying Cyber Bulling
Dealing with Anger and Managing Emotions
Friendship and Support Networks
Keeping Out of Fights
Listening and Conversation
Manners and Giving a Compliment
Peer Pressure/Avoiding Trouble
Playing a Game/Sportsmanship
Relaxation and Coping Strategies
Responding to Teasing and Embarrasment
Safety/Internet and Social Media
Using your time
Wanting Something That isn't Mine
When you Fail
Comments (If other was selected, please expand here.):
By submitting this form, I understand that acceptance into the group is based on match and suitability of the cohort. Enrolment is not guaranteed.
Yes, I agree
Tutoring Information (Tutoring for Fall - Winter term is currently full; Please reach out to us to be put on the waitlist!):
Our staff create individualized programs for students in Kindergarten to grade 8, and pair the students with tutors to work on basic subject areas such as math, reading, spelling, and writing. Tutoring runs from September 20th, 2021 to January 13th, 2022 for a total of 15 weeks (with holidays off). Students will attend Mondays and Wednesdays OR Tuesdays and Thursdays, from 4:00 to 5:00pm. The cost of tutoring is $300 for members ($10/hour) and $330 for non-members ($11/hour). A deposit of $80 is required at time of registration and the membership fee is $50 (optional). A staff member will contact you to arrange a one hour informal assessment to assess your child's abilities and needs prior to the start of their session. Tutoring is in-person and we aim to work one-to-one with each child, however, if we face a lockdown, students will be placed in small groups to transition the program online.
Are you interested in registering for our tutoring program?
Select your preferred tutoring days
Mondays and Wednesdays
Tuesdays and Thursdays
Current reading level (i.e., grade or DRA level)
Current math level (i.e., grade)
Has the student been identified with a learning disability?
Has the student been diagnosed with ADHD?
Does the student have difficulties with any of the following? (select all that apply)
Does the student have an Individual Education Plan (IEP)?
What do you want your child to work on?
Writing (could include sentence, paragraph, story, essay writing, etc.)
If 'other' was selected above, please expand upon what else should be worked on:
If applicable, please attach any relevant documents such as an IEP, three most recent report cards, psychoeducational assessments, etc.
Drag and drop files here
Choose a file
This helps us understand your child's strengths and needs all the better, which will allow for a program better fitted for them. All information sent to us will be kept confidential only to be shared among our staff.
Tutoring is made possible by the Municipality of Chatham-Kent.
Learning Disabilities Association of Chatham-Kent follows all Public Health guidelines and requirements for the operation of its in-person programs. Due to the unpredictable nature of COVID-19, Learning Disabilities Association of Chatham-Kent reserves the right to transition all in-person classes to a virtual environment in accordance with any recommendation by Health Canada or local public health authorities. When signing up for this program, you agree that in-person classes may be held online when deemed necessary. No refunds will be applicable to families who choose to withdraw from in-person programming, but participants will have the choice to withdraw and receive a partial refund if classes transition to online-based learning.
Yes, I agree.
If member, expiration month/year
How did you hear about our programs? Has your child been enrolled in a program previously?
Students are not considered enrolled until payment is received and staff have confirmed your time slot. Payment may be made via email money transfer to LDACK@netrover.com or cheque to PO Box 1424, Chatham ON N7M 5W8. If paying by e-transfer, please make your security question your child's name. If payment in full is not possible, please email LDACK@netrover.com to discuss payment plans. Talk to our staff if you have questions about becoming a member.
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