CACD 2025 FALL PROGRAM

Citizens for the Advancement of Community Development (CACD) is a youth-focused, Registered Charitable Organization dedicated to transforming the lives of BIPOC youth between the ages of 10 and 24. Since 2002, CACD has worked with the communities to transform the lives of youth through programming that:serves their unique needs, develops leadership capabilities, and fosters civic participation

CACD FALL VIRTUAL 2025 PROGRAM

Parental Consent Form (High School)

(October 14th - December 11th, 2025 Tuesdays and Thursdays from 4:00 -6:00 pm) Virtual through Zoom

Citizens for the Advancement of Community Development (CACD) is very honoured to provide an innovative Spring Program for your child(ren Our Fall Program is designed to equip your child/children with life skills through creative and enjoyable structured programming. These skills will be learned through integration with artistic activities.

participate in the CACD Fall High School Program.

the parent/guardian of give permission for my son/daughter to

Iunderstand that the facilitators are qualified/trained volunteers and professionals who have been carefully screened by the organization. I reserve the right to withdraw my child from the program at any time. I have read and understood the contents enclosed in this form.
Parent/Guardian Name
Child Name
Date

MonthDayYear
Date
Signature

Clear
1275 Mississauga Valley Blvd, Mississauga, ON L5A 3R8
CACD FALL SESSION PROGRAM INTAKE FORM
NAME
Date of Birth

MonthDayYear
Date
ADDRESS
EMAIL Participant
example@example.com
PHONE #
EMERGENCY CONTACT
Gender

MF
RELATIONSHIP
PHONE NUMBER
School
Grade
I hereby give Citizens for the Advancement of Community Development (CACD) permission to use photographs or any other visual media for public relations and promotion in any of the following communications and activities resulting from this program:

CACD Websites CACD Newsletters
Name Participant
Name Parent Guardian
Phone Number (Parent/ Guardian)
Address
Email Parent Guardian
example@example.com
Signature of Parent or Legal Guardian

Clear
Date

MonthDayYear
Date
Should be Empty:

CACD FALL SESSION PROGRAM INTAKE FORM