MMS Debate form 
Location: Dar Foundation ( 485 Morden Rd, Oakville ) 
Date & Timings: November 26 & December 10. 5-7:30 PM
$20 for both sessions 
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Parent Email:  *
Phone Number: *
Parent First & Last Name: *
Child First & Last Name: *
Age:  *
How did you hear about the program? 
What kind of topics is your child interested in?
Does your child have any dietary restrictions?  *
Is it okay for your child to be in photographs for our social media?  *
Please E-transfer $20 for your child to this email:

jawayriaq@gmail.com

Please include your childs name in the message section 
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