About Us
Accessibility
Clients Rights & Responsibilities
History
Indigenous Land Acknowledgement
Model for Health & Well Being
Privacy Statement
Teams
Vision & Mission
Governance
Partners
Join Us!
Careers
Membership
Students
Volunteering
Donate
Search for:
Home
Services
Health
Mental Health
Autism
Respite
Child, Youth & Family
Developmental Services
News
Events & Workshops
Contact
Home
About Us
Join Us!
Governance
Partners
Services
Autism
Child, Youth & Family
Developmental Services
Health
Mental Health
Respite
News
Events & Workshops
Contact
Please take a moment to complete our
New Website – User Feedback Survey
Lanark Site – Fit For Life Active
Home
Services
Health
Physical Activity & Fitness
Lanark Site - Fit For Life Active
If you need any assistance with registering, please contact Pam at 613-259-2182, ext. 2306 or Kara at 613-259-2182 ext. 2302
I would like to register for the following:
(Required)
(Up to three choices only please)
Ferguson Falls Hall, Tuesdays, 9:00- 10:00 am space still available
Middleville Hall, Mondays, 9:00 - 10:00 am space still available
Middleville Hall, Thursdays, 9:00 - 10:00 am space still available
Snow Road Hall, Wednesdays, 9:30 - 10:30 am space still available
St. Andrew's Church, Lanark, Wednesdays, 9:30 - 10:30 am space still available
Tatlock Hall, Tuesdays, 9:00 - 10:00 am space still available
Watson's Corners, Mondays, 9:00 - 10:00 am space still available
Watson's Corners, Fridays, 9:00 - 10:00 am space still available
Zion Memorial Church, Carleton Place, Wednesdays, 1:00 - 2:00 pm space still available
Zion Memorial Church, Carleton Place, Fridays, 1:00 - 2:00 pm space still available
Name
(Required)
First
Last
Preferred Name (if different from above)
Date of Birth
(Required)
DD slash MM slash YYYY
Address
(Required)
Street Address
Address Line 2
City
Alberta
British Columbia
Manitoba
New Brunswick
Newfoundland and Labrador
Northwest Territories
Nova Scotia
Nunavut
Ontario
Prince Edward Island
Quebec
Saskatchewan
Yukon
Province
Postal Code
Telephone Number (Please provide only numbers where you permit us to call)
Preferred
(Required)
Message Allowed
(Required)
Yes
No
Alternate
Message Allowed
Yes
No
Email
(Required)
Please provide an email address that you permit us to use to contact you.
Emergency Contact
Name
(Required)
First
Last
Relationship
(Required)
Phone Number
(Required)
Privacy
As a participant of this group, I will respect the privacy and confidentiality of other individuals in the group.
(Required)
Yes
Share This
Facebook
Twitter
