Survival Class
Application Form
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Email *
Phone Number *
Name *
Childs Name *
Childs DOB *
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Date Applied *
MM
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Preferred Start Date *
Does your family enjoy spending time outdoors? *
How much time per day is your child outdoors, on average? *
Not a lot
TONS!!
What is your child's favorite thing to do?
How much screen time is your child allowed on average, per day? This includes TV, YouTube, Tablets, Phones and Video Games *
If your child does not like the activity, how will he/she react? *
If your child acts out at home, how is he/she disciplined? *
The tuition is $160 / month, invoiced monthly. Can you commit to this payment for a 10 month contract? (Sept - June) *
Will the designated drop off and pick up spots be achievable? *
Yes
No
Mostly, I may need a carpool option for some days
West Kelowna
Downtown
East Kelowna
Kettle Valley
I would prefer a single location
Why do you think your child would be a good fit for our Survival Class? *
Does your child have any cognitive, behavioral or physical challenges that you know about? If yes, please describe.(eg. - Allergies, Medication, ASD, former injuries ... etc) *
If there was something your child needed to work on what would it be? *
Required
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