CACD 2025 FALL PROGRAM

CITIZENS FOR THE ADVANCEMENT OF COMMUNITY DEVELOPMENT

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 IN PERSON 2025 PROGRAM

Parental Consent Form (Middle School)

(October 15th - December 10th, 2025 Mondays and Wednesdays from 3:30 -5:30 pm)

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. the parent/guardian of give permission for my son/daughter to participate in the CACD Fall Middle School Program.

I understand 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.
Name (Parent/Guardian)
Name (Participant)
ParentGuardian Signature

Clear
Date

MonthDayYear
Date
1275 Mississauga Valley Blvd, Mississauga, ON L5A 3R8 (905) 277 - 8455
CITIZENS FOR THE ADVANCEMENT OF COMMUNITY DEVELOPMENT
CACD FALL SESSION PROGRAM INTAKE FORM
NAME
Date of Birth

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

MF
EMERGENCY CONTACT
RELATIONSHIP
PHONE NUMBER
School
Grade
CITIZENS FOR THE ADVANCEMENT OF COMMUNITY DEVELOPMENT

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:

CITIZENS FOR THE ADVANCEMENT OF COMMUNITY DEVELOPMENT

CACD FALL SESSION PROGRAM INTAKE FORM