Registration for the Fall 2024 Sessions will begin August 1st!

Spectrum Registration Form

The Child's Information

Please answer all questions. Do not leave any fields blank; type 'none' or 'n/a' as appropriate.

Complete Legal Name Required

Program

Address Required

Gender Required

Birthday Required

Americas/Vancouver

School Required

Grade Required

Name and Age of Siblings Required

Food Allergies? Required

Any medical condition you feel we may need to be aware of in the event of a medical emergency? Required

Parent or Guardian Information

Parent or Guardian Name Required

Parent or Guardian Relationship to Child Required

Parent or Guardian Phone Number Required

Parent or Guardian Email Required

I give my consent for my child to participate in the Rainbows or Spectrum program at St Mary's School Prince George. If joint custody your partner MUST also give consent. Required

Yes

Emergency Contact Information

Emergency contact must be different than the parent or guardian listed above.

Emergency Contact Name Required

Emergency Contact Relationship to Child Required

Emergency Contact Phone Number Required

Emergency Contact Email Required

Loss Information

Description of the losses Required

When did the losses occur Required

Has the child experienced any additional major losses within the past year. Required

Is the child attending counselling? Required

Anti-SPAM check 0% complete.

Our Office

Contact Us

1088 Gillet Street
Prince George, BC
V2M 2V3

250.562.3477
rainbowspg@shawcable.com