G1 Information Session Registration

Big Brothers Big Sisters of Peel York is excited to be partnering with Peel Regional Police to offer a G1 Driver’s License Information Session. This presentation is open to young people who are almost 16 years old or those 16+ wanting to prepare for getting their G1 driver’s license!

This session will be held at Big Brothers Big Sisters of Peel York’s Brampton office (71 West Drive #23, Brampton, ON) on Wednesday, May 27th from 6pm – 8pm.

To join us for this information session, please fill out the registration form below! Dinner, snacks, and drinks will be provided for all youth attending.

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This field is for validation purposes and should be left unchanged.

PARTICIPANT INFORMATION

Youth's Name*

First Last Preferred Name (if applicable)

Pronouns (Optional)

Youth's Date of Birth*

Parent/Guardian's Full Name*

Parent/Guardian's Email Address*

Does your child have any accessibility, learning or behavioural needs that we should be aware of?*

We realize that this information can be sensitive in nature. It will be treated with confidence and respect.

Yes

If yes, please provide details:

Does your child have any allergies or dietary restrictions?*

Dinner, snacks and drinks will be provided to all youth attending.

Yes

If yes, please provide details:

Youth Pick-Up & Dismissal Authorization*

Please select the option that best describes how your child will leave the program at the end of the workshop.

My child has permission to leave the program on their own

My child must be signed out by me, or another authorized pick-up person, at the door

Please enter the name(s) of adults authorized to pick up your child.*

Media Consent

I hereby consent to Big Brothers Big Sisters of Peel York (BBBSPY), the use of any photographs, audio and/or video recordings of my child taken during the program as authorized by the BBBSPY President & CEO or Board of Directors. I give my permission for this media to be used by BBBSPY for purposes of promotional material including brochures, posters, newsletters, media information, advertisements, audio-visual productions and digital media, (such as the BBBSPY website and social media). Photographs or video productions may also be shared with community and school partners for program promotion.*

Yes, I give Media Consent

No, I do not give Media Consent

Informed Consent

I hereby give permission to Big Brothers Big Sisters of Peel York to make available their service to my child. It is my understanding that the intention of the Agency is to offer my child an opportunity to participate in a group program lead by a responsible adult, (minimum 18 years old, however, where appropriate supervision takes place, the volunteer may be younger), I understand that all efforts will be made to select a responsible Mentor who will facilitate the group program. In consideration for this service and other valuable consideration provided to my child by Big Brothers Big Sisters of Peel York, I release the agency of all responsibilities and liabilities in connection to their services provided in good faith, to myself or my child. I permit the agency to release any relevant information, including my personal information, to Big Brothers Big Sisters of Canada and their insurers, as may be appropriate in connection with any legal proceeding, inquiry or risk thereof. I understand that the collection of personal information about me or my child will be held in strict confidence and is to be used solely for the purposes of administering the program. I further agree that information about my child may be shared, at the discretion of Big Brothers Big Sisters of Peel York, with the group facilitator so that my child’s needs may be best met. I understand that this application is the property of Big Brothers Big Sisters of Peel York.*

Yes. I have read and understand this agreement. I acknowledge that I am the parent/guardian of the child for whom I am applying and that I hereby request Big Brothers Big Sisters service for my child. I give my child permission to participate in one or more group programs offered by BBBSPY. I am aware of and understand the risks, dangers and hazards associated with the above service and agree such service is suitable for my child.

Parent/Guardian Signature*