CACD 2026 SPRING (Middle School) 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

Citizens for the Advancement of Community Development (CACD) is very honoured to provide an innovative Spring Program for your child/Children. Our Spring 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.

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 of this form.
Child Name
Date

MonthDayYear
Date
Signature
1275 Mississauga Valley Blvd, Mississauga, ON L5A 3R8
CACD WINTER SESSION PROGRAM INTAKE FORM
Parent/Guardian Name
NAME
Date of Birth

MonthDayYear
Date
ADDRESS
EMAIL Participant
example@example.com
PHONE #
Format: (000) 000-0000.
EMERGENCY CONTACT
MF
RELATIONSHIP
PHONE NUMBER
Format: (000) 000-0000.
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)
Format: (000) 000-0000.
Address
Email Parent Guardian
example@example.com
Signature of Parent or Legal Guardian
Date

MonthDayYear
Date
Should be Empty:

CACD WINTER SESSION PROGRAM INTAKE FORM