Please register for the program by completing the form below.

Summer Harvest Cooking Program

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Fields marked with * are mandatory.
Personal Information
*First Name
*Last Name
*Age
*Gender
* Date of Birth (YYYY-MM-DD):
Please fill in at least one of the two phone number input boxes
*Phone:
*Mobile:
*Email
*Address
*Postal Code
*City
*Province
*School Name
*Grade
*Education
Emergency Contact:
*Emergency Name
*Emergency Phone
*Emergency Relationship
Immigration Status and Information
Immigration Status
Country of Origin:
*Home Language:
Parent/Guardians Authorization
By signing this authorization you are agreeing to the following statements ( Please note that CICS stands for Centre for Immigrant and Community Services) * Participants should take care of their own safety. The agency is not liable for any personal loss or damage.
I hereby give CICS the right to obtain media recording including but not limited to photographs and videos of myself for promotional and any other uses by CICS through its media outlets.
I hereby give permissions to CICS to deliver agency information to my email address.
* For refund conditions, please make reference to our agency’s refund policy.
Any conditions (medical/physical/other concerns) that we should be aware of
* Security Number: Type the numbers you see in the block
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