2026 Youth Connections Registration

2026 Youth Connections Registration

Community Living Kincardine & District
Youth Participant
Youth Name *

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Youth Phone Number (if they have one)
Please enter a valid phone number.Format: (000) 000-0000.
Youth Email (if they have one)
example@example.com
Parent / Caregiver
Parent / Caregiver Name *

First NameLast Name
Parent / Caregiver Phone Number *
Please enter a valid phone number.Format: (000) 000-0000.
Parent / Caregiver Email *
example@example.com
Emergency Contact
Alternative Emergency Contact

First NameLast Name
Emergency Contact Phone
Please enter a valid phone number.Format: (000) 000-0000.
Does the youth participant have any allergies or medical conditions that the YC Leader should be aware of? Do they use any mobility or communication devices?
What is their communication style? (verbal/non-verbal, uses assistive communication device, sign language etc)
What strategies do you use to motivate them or redirect when necessary? What tips do you have for giving them instructions or providing feedback?
What advice or information would help make their participation more successful or enjoyable?
Youth Connection Session Planning

Throughout the summer, the Youth Connections Leader organizes sessions with individuals or small groups. Program fees cover costs associated with activities, staff and program administration.
I am interested in registering the youth participant for (check all that apply):

Individual sessions (1 to 1) - $20/hrSmall group sessions (1 - 3hrs) - $12.50/session
We would be interested in signing up for sessions that are scheduled:

On weekdaysEveningsOn weekends
To assist the YC Leader with planning activities, please share more information about the type of activities the youth participant would be interested in participating in:

Skill DevelopmentRecreation / LeisureCommunity ExplorationVolunteering or Pre-EmploymentSocial Activities
For "Skill Development", please share some example goals or activities your youth might be interested in. (eg. working on road safety, life skills, studying for Driver's License, cooking and baking, use of technology)
For "Recreation and Leisure", please share some examples your youth might be interested in. (eg. walking the trails, taking a yoga class, working out at the gym, participating in a sports league, taking an art class, swimming)
For "Community Exploration", please share some examples your youth might be interested in. (eg. using the library, shopping at Market in the Park, visiting tourist attractions)
For "Volunteer or Pre-Employment", please share some examples your youth might be interested in. (eg. specific volunteer locations, community events, groups or activities, developing a resume or cover letter, learning about jobs in the community)
For "Social Activities", please share some examples your youth might be interested in and who they might be interested in spending time with. (eg. organizing 'get togethers', going out for food or drinks, playing board games with peers, attending festivals or community events)
In the past, Youth Connections have taken day trips to nearby communities and attractions. Please share any favourite trip locations from past years or ideas for future trips.
Please share any other considerations or information that may assist the Youth Connections leader to support the youth to have a great summer!
Should be Empty:

2026 Youth Connections Registration

Youth Participant

Parent / Caregiver

Emergency Contact

Youth Connection Session Planning