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Children: Friendship Club: Registration

2024 Friendship Club Registration

Please complete the below form to register for the Friendship Club Program. A separate form must be submitted if you are registering more than one child. We will be in touch confirming registration, program start dates, locations and times.

Step 1 of 4

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Child's Name*
First Last
Date of Birth*
Month
Day
Year

Month/Date/Year
Age*
School attending in September 2024
Grade (as of Sept. 2024)*
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Parent's Name*
First Last
Home Phone*
Cell Phone*
Work Phone
Email*
Parent's Name*
First Last
Home Phone*
Cell Phone*
Work Phone*
Email*
Emergency Contact*
First Last
Please list someone other than parents listed above who would be available during program time.
Relation to Child*
Emergency Contact Number*

Has your child been formally diagnosed with a Learning Disability?*
- Yes
- No
- I don’t know
** Please note that your child does not have to be formally diagnosed to participate in our programs.
If yes, type of LD:
- Phonological Processing
- Language
- Visual-Motor
- Visual- Spatial (Perceptual Skills)
- Memory
- Processing Speed
- Executive Function
- Other
Comments:
Does your child have an AD(H)D diagnosis:*
- Yes
- No
- I don’t know
If yes, type of Attention Disorder (i.e. Inattentive, Hyperactive)
Specify what areas your child struggles with beacuse of their learning disability, even if there is no formal diagnosis (i.e. social skills, reading, writing, math):*
Has your child been diagnosed with any other exceptionalities (i.e. Autism Spectrum Disorder, Developmental Disability)? Please list any exceptionalities:*
Please identify any behavioural challenges & plans that LDATD staff should be aware of :*
Any additional information we should know:

Is your child on an IEP?*
- Yes
- No
- I don’t know
Placement at school:*
- Regular Class
- Regular Class Withdrawl Support
- Special Class
- Other
Comments:
Tell us about your child's learning style.*
What are some of your child's strengths?*
What specific areas/goals would you like to see worked on in the program?*
- Establishing Friendships
- Emotional Awareness
- Non-Verbal Communication
- Active Listening
- Problem Solving
- Cooperation and Compromising
- Approachability and Making Plans
- Dealing with Bullying
- Self-Esteem and Confidence
Please list 1 specific goal you would like to see addressed in our program.*
Has your child attended any other Social Skills programs or therapy? If yes, please specify.
What accomodations, if any, have successfully helped your child in the classroom?*
Additional comments that will assist us in educating your child:
Please describe any other areas that you feel your child might need extra support, aside from Social Skills.
How did you hear about our Program?*
- Online Search
- Online Ad
- Flyers, pamphlet, ect.
- LDATD staff
- Friend/Family
- External Referral (Doctor, Dentist, Social Worker)
- Other
If other, how did you hear about our Program?

Please choose a session date:*
- ONLINE- 3 weeks(2 days per week)- January 6 – January 24
- ONLINE- 3 weeks(2 days per week)- January 27 – February 14
- ONLINE- 3 weeks(2 days per week)- February 17 – March 7 *No program February 17 (Family Day)
- ONLINE- 3 weeks(2 days per week)- March 10 – March 28
- ONLINE- 3 weeks(2 days per week)- March 31 – April 18 *No program April 18 (Good Friday)
- ONLINE- 3 weeks(2 days per week)- April 21 – May 9 *No program April 21 (Easter Monday
- ONLINE- 3 weeks(2 days per week)- May 12 – May 30 *No program May 19 (Victoria Day)
- ONLINE- 3 weeks(2 days per week)- June 2 – June 20
- ONLINE- 6 weeks (1 day per week)- January 6 – February 14
- ONLINE- 6 weeks (1 day per week)- February 17 – March 28 *No program February 17 (Family Day)
- ONLINE- 6 weeks (1 day per week)- March 31 – May 9 *No program April 18 (Good Friday) & April 21 (Easter Monday)
- ONLINE- 6 weeks (1 day per week)- May 12 – June 20 *No program May 19 (Victoria Day)
- IN-PERSON-Etobicoke- Thursdays- 6 weeks (1 days per week)- January 9 – February 13
- IN-PERSON-Etobicoke- Thursdays- 6 weeks (1 days per week)- February 20 – March 27
- IN-PERSON-Etobicoke- Thursdays- 6 weeks (1 days per week)- April 3 – May 8
- IN-PERSON-Etobicoke- Thursdays- 6 weeks (1 days per week)- May 15 – June 19
- IN-PERSON-North York-Saturdays-6 weeks (1 days per week)- January 11 – February 15
- IN-PERSON-North York-Saturdays-6 weeks (1 days per week)- February 22 – March 29
- IN-PERSON-North York-Saturdays-6 weeks (1 days per week)- April 5 – May 10
- IN-PERSON-North York-Saturdays-6 weeks (1 days per week)- May 17 – June 21
- BeFriend Youth- Online
Option 1: ONLINE- 6 week Session- 1 day per week with various dates Option 2: ONLINE- 3 week Sessions- 2 days per week with various dates Option 3: IN-PERSON- 6 week Session- 1 day per week with various dates and locations **Flexible options available. Please complete the form and discuss additional options with the Program Coordinator.
This field is hidden when viewing the form
Please select choices for class times:*
- Weekday Mornings
- Weekday Afternoons
- Weekday Evenings
We will match you with a virtual instructor and confirm times by phone or email.
ONLINE PROGRAM-Please specify preferences for days of the week and times:
**We will do our best to meet your needs, however our flexibility is dependent on staff availability.
Consent
I agree to the policies below:
Privacy Agreement:
This agreement is designed to provide LDATD clients with a private and secure means of gaining and using information. LDATD is committed to protecting your privacy. All data you provide to us is confidential. LDATD will not record online classes, take photos or screenshots without written parental consent.

By registering for this program, you agree that you will not record classes, take photos and screenshots or share or duplicate LDATD material without written permission.

Links to Other Sites:
On LDATD’s Online Platform, you will find links to websites whose content we believe will be helpful for our clients. Once you leave our website, the use of any information you provide is governed by the privacy policy of the operator of the site you’re visiting. We do not necessarily endorse the opinions expressed by the website you are visiting outside of LDATD’s Online Platform.

Parental Supervision:
LDATD is not responsible for misconduct of participants through messaging, video and screen sharing tools. Parents/guardians are responsible for supervision and safety of their children/youth during program time.
Consent*
I agree to the refund policy
LDATD In- House Programs Refund/Cancellation Policy:
Please Note:
• We do not offer makeup classes. Missed program dates
will not be refunded and time will not be made up.
• Spaces cannot be held until payments have been arranged

Refund Policy:
• 80% of the program fee will be refunded on cancellations received 10 or more business days prior to the start of the program. Refunds will only be honored on full payments.
• 50% of the program fee will be refunded on cancellations received less than 10 business days prior to the program start date. Refunds will only be honored on full payments.
• No refunds will be issued on or after the first day of program **Refunds may be considered in exceptional circumstances. Please submit requests via email to [email protected]
• Cancellation notice/refund requests must be submitted in writing via email to [email protected].
• LDATD reserves the right to cancel a program and will offer a full refund
Total
$ 0.00 CAD
Please continue to the next screen to submit your application. You will receive a welcome email following completion of payment. Please check junk mail folders for this email. If you do not receive the welcome email, please connect with us at [email protected] Thank you!
Payment Method*

MasterCard
Visa
Supported Credit Cards: MasterCard, Visa
Card Number Expiration Date Security Code Cardholder Name

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Re-Registration for Online Programs

Children: Smart Kidz Tutoring: Registration

Children: Assistive Technology: Registration

Children: Keyboarding for Kids: Registration

Children: Yearly Camps: March Break Keyboarding & Friendship Club For Kids: Registration

Children: Yoga & Mindfulness: Registration

Children: Yearly Camps: March Break Friendship Club: Registration **REGISTRATION CLOSED FOR 2024

Children: Yearly Camps: Summer Keyboarding For Kids: Registration

Children: Yearly Camps: Summer Friendship Club: Registration

Children: Yearly Camps: Summer Yoga & Mindfulness: Registration

Youth: Befriend: Registration

Youth: Y.I.E.L.D (Youths’ Initiative and Excellence with LD’s): Registration

Youth: H.I.R.E. (Youth Help in Reaching Employment): Registration

Youth: Smart Kidz Tutoring Registration

2021 In-Person Program Waitlist

Youth: Y.E.L.P (Youth Empowerment & Leadership Program): Registration

Youth: Typing for Teens: Registration

Youth: Yoga & Mindfulness: Registration

Get in Contact

Head Office

Open Monday - Friday

T: 416.229.1680

E: [email protected]

Settlement Office

Open Monday - Friday

T: 647.531.1680

E: [email protected]

Employment Office

Open Monday - Friday

T: 416.229.1680

E: [email protected]

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Learning Disabilities Association of Toronto