YAAACE Program Registration

YAAACE PROGRAM REGISTRATION FORM
Yes, I would like to put my child on the waitlist for Summer Institute.
example@example.com
DISCLAIMER

YAAACE is a non-profit organization that heavily relies on various grants from the Provincial and Federal Government, as well as other organizations. The following information requested below will be used for internal reporting measures to help determine the need in our community and obtain additional funding and resources to subsidize the cost for all of our participants with the hopes of making all future programs free of cost. We ask that you answer these questions as accurately as possible.

Please note that all data provided on this form will not be shared or sold, and is collected solely in order to evaluate YAAACE programs and their impact on the community that we serve.
PARTICIPANT INFORMATION
Student Name*

First NameMiddle NameLast Name
Sex*

MaleFemalePrefer Not to Say
Preferred Pronouns*

He/HimShe/HerThey/Them
Has this student registered for any other YAAACE programs in the past?*

YesNo
If so, please select which programs this student has previously participated or are currently participating in. (Select all that apply)*

NALE TutoringRoboticsSmall BallDrop-In Development DaysBreak Camp (Free)Summer InstituteBreaking for DevelopmentYouth Basketball LeagueYAAACE Rep Basketball TeamHigh Performing Athletics Camp (March Break)
Date of Birth*

MonthDayYear
Date
Current Grade*
Current School*
Student OEN*
Do not include dashes. This number can be found on the student report card
Does this student play on any sport Rep teams?*

NoOther
Shirt Size*
Required for camp and sports programs only
Home Address*

Street Address

Street Address Line 2

CityProvince

Postal Code
Student Email (optional)
example@gmail.com
Student Cell Phone # (optional)

Area CodePhone Number
Student Instagram Handle (optional)

BILLING AND EMERGENCY CONTACT INFORMATION
Parent/Guardian*

First NameLast Name
Parent/Guardian Phone Number*

Area CodePhone Number
Email (to be used for billing and program correspondence)*
ALL CORRESPONDENCE AND INVOICES WILL BE SENT TO THIS EMAIL ADDRESS. PLEASE ENSURE IT IS ENTERED PROPERLY.
Is this person also the Primary Contact?*

YesNo
Primary Contact Name

First NameLast Name
Relation to Student
Phone Number for Primary

Area CodePhone Number
Email for Primary
example@gmail.com
SECONDARY CONTACT INFORMATION

This person will be contacted if we are unable to reach the parent/guardian/primary contact.
Secondary Contact Name

First NameLast Name
Relation to Student
Phone Number for Secondary

Area CodePhone Number
Email for Secondary
example@gmail.com
END OF DAY SIGN OUT AUTHORIZATION
I allow my child to leave the premises on their own at the end of the day. I hereby inform YAAACE that my child has my permission to walk home after the end of programming without adult supervision. I acknowledge YAAACE will no longer be responsible for my child after they have left school property.

YesNoNot Applicable
In addition to the emergency contacts named above, I hereby provide authorization to the following additionally named persons (over the age of 16) to pick up/sign out my child at the end of day. I understand that they may be asked to show ID. Their name(s) and contact number(s) are as follows:
ADDITIONAL INFORMATION
Ethnicity*

CaribbeanAfricanIndigenousSouth AsianSouth East AsianEast AsianHispanicEuropeanMixedPrefer not to sayOther

Have you or a family member had contact with the Criminal Justice System?*

YesNo
How did you hear about YAAACE (Please select all that apply)*

TDSB/TCDSB School BoardInstagramSchool Administrator (teacher/principal/guidance counsellor)Family/FriendCurrent ParticipantPast ParticipantEmailFlyerNews/NewspaperYAAACE employeeOther
RELEASE AND ACKNOWLEDGEMENT
I, {parentguardian169}, acknowledge that the registration and demographic data provided within this form will be used for research purposes only. I hereby provide my consent to allow the organization to use this information.*

Yes, I agreeNo, I would like to opt out
I, {parentguardian169}, acknowledge that photographs and video may be taken of my child while participating in YAAACE programming and posted to social media, news releases, publications or archived for future use. I further acknowledge that by providing the instagram handle of my child, they may be tagged by the organization in posts for engagement and relationship-building purposes only, and that I have the option to opt out or can provide this information at any time by contacting the organization and that it will not monitored or shared by staff. I hereby provide my consent to allow the organization to use those images solely for their not-for-profit purposes and waive the right to any and all compensation stemming from the use of these materials.*

Yes, I agree
I understand that non-payment of program fees (where applicable) will result in my child losing their spot in the program.*

Yes, I understand
YAAACE PROGRAMS*
prevnext( X )
Breaking for Development$ FreeCAD
(Ages 6-18) We are looking to grow a group of 30 passionate young dancers between the ages of 6 - 18. Youth will receive FREE breaking training and lessons with professional instructors.

NALE Tutoring Program$ FreeCAD
(Grades 1-12) Free numeracy and literacy tutoring based on TDSB and TCDSB curriculum to help students in Grades 1 - 12. Classes take place on weekday evenings and Saturday afternoons. (Class times to be determined by grade).

Small Ball Program $100.00CAD
(JK-Grade 6) WINTER 2025 SESSION (8 WEEKS) starting January 11, 2025: Led by certified coaches and trainers, children engage in recreational play and develop transferable skills for both the basketball court and in the classroom.

Robotics Pre-Registration$ FreeCAD
(Grades 4-8) Explore robotics and coding taught by Toronto Police Services, Integrated Gun & Gang Task Force and First Robotics Canada in partnership with #Engage416. Limited to 10 cohorts per season on a first come, first serve basis. More than 2 missed classes will result in removal from the program.

Community Days (Sunday Drop in) Gr. 6-12 ONLY$ FreeCAD
Developmental basketball and character education for the Jane and Finch Community for youth in grades 6-12. Free to students in the Humber River - Black Creek catchment. 1 hr of skills training and 30-45 minutes of scrimmaging,

Total $0.00CAD
Individual invoices (where applicable) will be emailed for each program once registration is complete.
Should be Empty:

	Yes	Brief Description
Allergies to food/ medicine
Does the child carry an epi-pen
Other medical conditions
None

	Less than 40k	Between 40-60k	Between 50-80k	Over 80k
Single Income Household
Dual Income Household

YAAACE PROGRAM REGISTRATION FORM

END OF DAY SIGN OUT AUTHORIZATION

ADDITIONAL INFORMATION