Name:

Street Address:

City/Province:

Postal Code:

Phone Number:

Email:

Affiliation (student, teacher, psychologist etc):

Number of attendees:

Which workshop(s) are you registering for?

($20) Health Care Professional Day (April 24)
($20) An Evening for Parents, Families and Communities (April 24)
($20) Open session with teachers, coaches and community health workers (April 25)

Additional information: