Covid-19 Vaccination Clinic Registration
Fill out this form to register for the vaccination clinic being hosted by the FCT on Saturday, June 25th, 2022, from  9:30 am to 1:00 pm. We also take registration by email and phone number

1st, 2nd, 3rd, and 4th doses of mRNA vaccine are being administered, as well as vaccines for children. OHIP is not required.

For more info, please contact the Centre at 416-335-0485 OR Liezl Chavez at 416-239-5499
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WHAT IS YOUR FULL NAME? *
EMAIL ADDRESS
PRIMARY CONTACT NUMBER *
DATE OF BIRTH (DOB): *
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DATE OF LAST VACCINE *
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DD
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YYYY
Select which dose you would like to be administered.
What is your arrival time? (9am - 1pm) *
Time
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