Pickering Football Club All Abilities Fall 2024 First Involvement Participant Registration Form

Pickering Football Club All Abilities Fall 2024 First Involvement Participant Registration Form
The Pickering Football Club's All Abilities soccer program (PFC AA) offer children and youth with intellectual and/or physical disabilities an opportunity to participate in specially designed recreational opportunities. Every child deserves a chance to build lasting friendships, make memories and feel like they belong. The All Abilities team strives for an inclusive environment where no child is noticed for their disability, rather, their enormous abilities shine. Our programs are fully inclusive, designed and adapted for children with any disability or level of behaviour, whether they use a wheelchair, walker or wear orthotics, or live with an intellectual, communication (ASD) or developmental disability

Our First Involvement session for Fall 2024 will take place October 6th, 12:30pm to 1:30pm at the Pickering Soccer Centre (1975 Clements Rd, Pickering, ON L1W 4C2) and is designed to provide an opporunity for potential participants and their families/guardians to become familiar with our facility, staff and programming before registering. Come join us for an afternoon of fun!

Please complete this form in its entirety to RSVP. Feel free to contact Jarod at allabilities@pickeringfc.ca with any questions or concerns.
Participant Name*

First NameLast Name
Name of parent(s)/guardian(s)/caregiver(s) who will be attending with participant and relation to participant*
Contact email of parent/guardian/caregiver listed above (this will be used to receive communications and updates of the event from the program coordinator)*
example@example.com
Please tell us about the participant. Include likes, dislikes, potential goals for their time with the program, etc.*
Age of participant*
Medical Diagnosis of Participant (This information is NOT shared with anyone outside of program staff and is used the sole purpose of designing our sessions to best serve the participant). If your participant has no diagnosis, or you choose not to disclose, please answer N/A. *
Does your participant have any medical concerns we should be aware of (e.g. allergies, prone to seizures, physical impairments etc.)? If they do, are their any treatment options we should be aware of (e.g. participant's guardian will have their EpiPen). If no, please answer N/A*
Please tell us about any fears or anxieties the participant may have, so we can prepare to make them as comfortable as possible!*
What is the best way our program volunteers and staff can assist participant?*
We will have no volunteers to assist participants 1-on-1 at our First Involvement session on October 6th, as such we will require parents/guardians/caregivers to assist their athlete on field while our coaches direct the session*

I understand and agree to assist my participant on-field during games and activities
Should be Empty: