Registration for Fall 2015 Children’s Movement Program Name: Birthdate:
/ / day month year
M F
Age groups
Children aged 1* to 12 are welcome in the program. The session designed for ages 1 and 2 requires a parent to participate with the child. *Your child should be walking for at least 2 months prior to the start of the program.
Age as of September 1, 2015 Parent/guardian’s name:
What to wear?
Address:
Shorts/sweatpants and t-shirt (no zippers or buttons). If your child is wearing pants, please ensure that they do not drag on the floor.
City: Postal code:
NOTE: Many activities involve bare feet. Parents must remove shoes prior to entering the gym to keep the floor clean for the children.
Phone: E-mail: Time preferred: #1
Children’s Movement Program Fall 2015 Celebrating 20 years!
#2
Fee enclosed: $ Parking pass? $
Session times
TOTAL $ Please make cheques payable to “Brock University”.
9:00 am
1-2 yrs.
3-4 yrs.
5-7 yrs.
10:00 am
1-2 yrs.
3-4 yrs.
5-7 yrs.
11:00 am
1-2 yrs.
3-4 yrs.
8-12 yrs.
Medical information we need to know:
Fees (8 classes) Does your child have a special need? Y N Please give details:
Consent
Have you signed a parental assumption of risk and indemnity agreement form? Y N If not, please ensure that you obtain, read, sign and submit the consent form prior to your child’s participation in this program.
$62 (first child in family) $55 (additional children in same family) $35 (child of current Brock student) $17 (optional) 8-punch parking pass
Program dates Saturdays: No Class:
September 19, 26 October 3, 24, 31 November 7, 14, 21 October 10, 17
Coordinated by the departments of Athletics & Recreation & Kinesiology 905 688 5550 x4060 brocku.ca/recreation-services
The Children’s Movement Program The Children’s Movement Program incorporates the foundations of physical education, educational gymnastics, creative dance, and developmental games. The movement approach permits a variety of responses to tasks, fostering independence. It allows all children the opportunity to participate within an inclusive environment, aiding them in the development of self-discovery, fundamental movement and social skills. Each week, a new movement concept will direct your child’s movement skills. This unique opportunity for your children will offer them the chance to increase their movement potential and advance their social skills using a whole child approach to activities. Upper year university students will guide your children in developing new ways to move, develop transferrable skills, problem-solve and be creative. Parents or guardians are invited to observe their children while they participate. Children in the 1-2 age group must be accompanied in the activities by a parent/ guardian.
For children who have a special need... Volunteer movement partners (university students) are available to provide one-on-one interaction with your child and provide appropriate assistance to help your child actively participate in the program.
Where do I go?
CMP is held in Gym 2, Walker Complex, at Brock University. The Eleanor Misener Aquatic Centre is also located in the complex.
Parking at Brock University
Lot “D” is $7 per entry; however, program participants can purchase a 8-punch parking pass at the Welcome Desk for $17. Lot “P” is a “pay and display” lot that requires change or a credit card for payment of $3/hour.
To Register Online
brocku.ca/recreation-services Click the online registration link.
By mail
Dept. of Athletics & Recreation 500 Glenridge Avenue Brock University St. Catharines, ON L2S 3A1
In person
Walker Complex Welcome Desk Brock University
By phone
(with VISA/Mastercard/Discover) 905 688 5550, x4060
Protecting your information Personal information is collected under the authority of The Brock University Act, 1964, and in accordance with the Freedom of Information and Protection of Privacy Act (FIPPA) for the administration of the University and its programs and services. For details on the use and disclosure of this information call the Department of Recreation Services at 905-688-5550 x3574 or visit brocku.ca/ recreation-services