Online Program Registration Form
Using the latest neuroscience tools for innovation, social connection, and resilience, this online program guides children to develop the 5 future-ready skills of CQ: creativity, collaboration, communication, critical thinking, and contribution.

Program Dates: Tuesdays | November 3-December 1 (5-week program)

Time: 4:00pm-5:00pm (PST)

*Price: $15 per session = $75 CAD + GST

**Platform: Zoom
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*Payment is made via PayPal. Once you submit this form, you will find the PayPal link in the confirmation message.

**Zoom information details will be sent to your email one payment has been received.
Email *
Parent's First & Last Name *
Child's Name *
Child's Age | Grade *
What skills are you hoping your child can work on during these sessions? *
By checking this box, you understand these online classes may be recorded (in speaker view) and could be used for media promotions on our website and social media channels. If you want to opt your child out of the recording, please ensure their video is turned off. *
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A copy of your responses will be emailed to the address you provided.
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