Sign Up For Social/Recreation Events: May-June 2010
In order to confirm your spot on these trips please fill in the sign up form below. Please send this form to Laura Anderson 10 Overlea Blvd. Toronto, Ontario M4H 1A4 along with a cheque payable to the Ontario March of Dimes. Cheques should include the total payment for all participants, for all the trips that you wish to attend. No spot can be confirmed without payment or sign up form confirmation. Family and friends are welcome to attend, however, the focus of these trips is to allow young adults to socialize!
First Name:Last Name:
Home Address: City:
Phone Number:Alter. Phone Number:
E-mail Address:
Name of Family/friends attending:
Do you use a mobility device? Power Chair Scooter
Manual Chair None (ambulatory)
Dimensions of wheelchair: .
1.Are you able to Transfer to a Seat? Yes No
2.Will your chair fold? Yes No
3.Do you use a communication device? Yes No
Please describe:
4.Do you require one on one care? Yes No
I am interested in signing up for the following events:
Saturday, May 8, 2010- DRIVE IN MOVIE* 6:30pm-Late (times TBA)
*$17p.p (Includes transport from Toronto or Mississauga)
*# of Accessible Seats: .
*# of Participants Total: .
*Transport from: . /
Saturday, June 5, 2010- GLIDING
*Free for those with a disability*Transport from Toronto & Mississauga available.
*Limited number of spaces
*9am-6pm
* Note: Gliding is subject to proper weather conditions. Alternative dates have been scheduled as follows if weather conditions are not suitable: June 6, June 12 & June 13. Please also keep these dates open. Gliders will be called in the morning to verify if the trip will occur. Gliding conditions cannot be guaranteed and are subject to change. Please understand that some amount of flexibility is needed
*Hoyer lift available
Saturday, May 29, 2010- Bloorview Youth Dance
*No transport available. Meet at Earl Bales Community Centre 4169 Bathurst Street (Bathurst & Sheppard)
*7pm-10pm
*$3 at the door! Snacks included! / Saturday, June 26, 2010- ABLESAIL
*Try out sailing or take a tug boat ride for free
*Bring money for a BBQ lunch
*11am-4pm
*Hoyer Lift available
*limited transport available
*Meet at the Burlington sailing club
Terms & Conditions
Attendant Care: Attendant care is not provided. Attendants accompanying you must pay the full trip fee unless otherwise stated.
Meals: Please pack a lunch or dinner for those trips as meals are not provided.
Cancellation: A minimum number of participants are required for each trip or the trip will be cancelled. You will receive cancellation notice and your fee reimbursement will be mailed to you. Registrants canceling with a minimum of 30 days notice will receive a full refund. Registrants canceling with less than 30 days notice will not receive any refund unless their spot can be filled by another participant.
**Please mail this form to Laura Anderson 10 Overlea Blvd. Toronto, On. M4H 1A4. Including full payment for trips Questions? Call 1-800-263-3463 ext. 7250