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If you need any assistance with registering, please contact Pam at 613-259-2182, ext. 2306 or Kara at 613-259-2182 ext. 2302. If you are using a cell phone or tablet(I-Pad) it's best to turn it sideways to make entering information easier.I would like to register for the following:(Required)(Up to three choices only please) Ferguson Falls Hall, Tuesdays, 9:00-10:00 am (7 spaces remaining) Middleville, Thursdays, 9:00-10:00 am (7 spaces remaining) Snow Road Hall, Wednesdays, 9:30-10:30 am (8 spaces remaining) St. Andrew's Church, Lanark, Mondays, 9:30-10:30 am (7 spaces remaining) St. Andrew's Church, Lanark, Wednesdays, 9:30-10:30 am (4 spaces remaining) Tatlock Hall, Tuesdays, 9:00-10:00 am (9 spaces remaining) Watson's Corners, Monday, 9:00-10:00 am (1 spaces remaining) Watson's Corners, Fridays, 9:00-10:00 am (0 spaces remaining) Zion Memorial Church, Carleton Place, Tuesdays, 1:00-2:00 pm; (5 spaces remaining) Zion Memorial Church, Carleton Place, Thursdays, 1:00-2:00 pm (6 spaces remaining) 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 AlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNorthwest TerritoriesNova ScotiaNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukon Province Postal Code Telephone Number (Please provide only numbers where you permit us to call)Preferred(Required)Message Allowed(Required)YesNoAlternateMessage AllowedYesNoEmail(Required) Please provide an email address that you permit us to use to contact you.Emergency ContactName(Required) First Last Relationship(Required)Phone Number(Required)PrivacyAs a participant of this group, I will respect the privacy and confidentiality of other individuals in the group.(Required) Yes
