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  • ILDERTON PROGRAMS

    REGISTRATION FORM

  • We’re excited to offer engaging programs for children and youth in Ilderton through BGC RURAL HUBS,  NEXT LEVEL SPORTS (NLS) and RED CROSS TRAINING PROGRAMS. Each program is designed to build skills, confidence, and community while keeping participants active and connected.

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  • AGES 4-7

    MESS FEST

    Get messy and have a blast! Explore creativity through hands-on sensory activities like paint, slime, and sand. This single night event encourages imagination and playful learning in a safe, supervised space where the bigger the mess means more fun!

    📍 Location: Ilderton Youth Centre 
    🗓 Date: Tuesday, June 9, 2026
    ⏰ Time: 5:30-6:30 PM 
    💲 Cost: $20

    AGES 8-12

    STEM STUDIO

    STEM Studio invites youth to dive into science, technology, engineering, and math through hands-on experiments, building challenges, and creative problem-solving. Each week, participants investigate new concepts, test ideas, and bring their own inventions to life, sparking curiosity, critical thinking, and a love of discovery.

    📍 Location: Ilderton Youth Centre
    🗓 Date: Mondays, May 25, June 1, June 8, and June 15
    ⏰ Time: 6:00-8:00 PM 
    💲 Cost: $80 | Maximum 20 participants

     

    PIZZA & PAINT NIGHT 

    A fun, evening where participants paint their own masterpieces and make personal pizzas. This single night event combines creativity, food, and social fun while providing the opportunity to try something new and leave with a tasty treat and unique creation.

    📍 Location: Ilderton Youth Centre
    🗓 Date: Tuesday, June 2, 2026
    ⏰ Time: 6:00-8:00 PM 
    💲 Cost: $20 

     

    TACO & TIE-DYE NIGHT 

    A colourful, evening where participants create tie-dye designs and make tasty tacos, blending creativity, cooking, and social fun, with a unique keepsake to take home.

    📍 Location: Ilderton Youth Centre
    🗓 Date: Tuesday, June 16, 2026
    ⏰ Time: 6:00-8:00 PM 
    💲 Cost: $20

      

    Cancellation and Refund policy 

    **Once the program starts, no refunds will be given. Any refunds must be requested at least 24 hours before the start of the program and may be subject to a $15 administration fee.

    ✅ Please contact Whitney Brown at wbrown@bgclondon.ca for more information

  • RED CROSS COURSES

    ✅ Please contact Training@bgclondon.ca for more information

      

    Cancellation and Refund policy 

    **Once the program starts, no refunds will be given. Any refunds must be requested at least 24 hours before the start of the program and may be subject to a $15 administration fee.

     

  • Athlete Information

  • Participant's Date of Birth*
     - -
  • Format: (000) 000-0000.
  • Format: (000) 000-0000.
  • Emergency Contact Information

  • Format: (000) 000-0000.
  • Did someone refer you to this program?
  • If yes, please fill in the name and email of the person who referred you below.

  • Participant Information con't

  • Does the participant have any medical conditions we should be aware of?*
  • Are there any medications that the participant is taking that we should be aware of?*
  • Does the participant have any dietary/fluid restrictions or allergies? (ex. gluten free, peanut allergy, thickened fluids, etc.)*
  • How did you hear about this program?*
    • Waiver 
    • BGC LONDON (BOYS & GIRLS CLUB OF LONDON)

      RELEASE OF LIABILITY, WAIVER OF CLAIMS

      ASSUMPTION OF RISKS AND INDEMNITY AGREEMENT.

       

      BY SIGNING THIS AGREEMENT YOU WILL WAIVE CERTAIN

      LEGAL RIGHTS, INCLUDING THE RIGHT TO SUE

      PLEASE READ CAREFULLY!       

    • TO:    Boys & Girls Club of London and the Boys & Girls Club of London Foundation (together the “BGCL”) and their directors, officers, employees, instructors, agents, representatives, volunteers, independent contractors, subcontractors, sponsors, successors and assigns (hereinafter collectively referred to as the “Releasees”).

       

      COVID – 19   COVID-19 is a contagious disease (“Covid”). We care about you, your family, our employees and the public. We strive to obey the law and follow Covid guidelines and implement all risk mitigation measures. However there are significant health risks and high risk of transmission through physical or shared contact. COVID-19 is novel and, because it can be transmitted through physical or shared contact with another person, the risk of contraction from engaging in sport activities may be foreseeable.

       

      ASSUMPTION OF RISKS

      I am aware that the activities at the BGCL programs involve risks and dangers that may cause serious injury and even death, and loss or damage to personal property. These risks are inherent in the activities and cannot be eliminated without altering their character and value. The risks include, among others, the following: contracting Covid;  moving about the BGCL premises; negligence on the part of myself and/or other participants; negligence of the BGCL and its staff, including the improper use of equipment; the breakage and failure of equipment and structures; over exertion, together with other risks which may be encountered and NEGLIGENCE ON THE PART OF THE RELEASEES, INCLUDING THE FAILURE ON THE PART OF THE RELEASEES TO SAFEGUARD OR PROTECT ME FROM THE RISKS, DANGERS AND HAZARDS REFERRED TO ABOVE.

       

      The BGCL programs are designed for use by participants of average strength, mobility and fitness who are in good health. Several medical
      conditions, including but not limited to obesity, high blood pressure, cardiac and coronary artery disease, pulmonary problems, arthritis, tendonitis, or joint and muscular-skeletal problems may impair the safety and well being of participants as may other medical, physical, psychological or psychiatric problems. All such medical conditions may increase the risk of participating in the programs and cause the participant to be a danger to themselves or others. Participants with underlying medical, physical, psychological or psychiatric conditions must evaluate their condition and their ability before choosing to participate in the programs. All participants must inform BGCL in writing of any such medical, physical, psychological or psychiatric conditions before participating in any programs. The Releasees reserve the right to prevent any person, for medical or safety reasons, from participating in the programs at any time.

       

      I AM AWARE OF THE RISKS, DANGERS AND HAZARDS ASSOCIATED WITH MY USE OF THE BGCL PROGRAMS AND I FREELY ACCEPT AND FULLY ASSUME ALL SUCH RISKS, DANGERS AND HAZARDS AND THE POSSIBILITY OF PERSONAL INJURY, DEATH, PROPERTY DAMAGE AND LOSS RESULTING THEREFROM.

       

      RELEASE OF LIABILITY, WAIVER OF CLAIMS AND INDEMNITY AGREEMENT

      In consideration of the Releasees permitting my use of the BGCL PROGRAMS and other facilities at the BGCL (hereinafter referred to as “the BGCL Facilities”), I hereby agree as follows:

       

      1. TO WAIVE ANY AND ALL CLAIMS that I have or may in the future have against the RELEASEES, and TO RELEASE THE RELEASEES from any and all liability for any loss, damage, expense or injury including death that I may suffer, or that my next of kin may suffer resulting from either my use of or my presence at or on the BGCL Facilities DUE TO ANY CAUSE WHATSOEVER, INCLUDING NEGLIGENCE, BREACH OF CONTRACT, OR BREACH OF ANY STATUTORY OR OTHER DUTY OF CARE, INCLUDING ANY DUTY OF CARE UNDER THE OCCUPIERS LIABILITY ACT, RSO 1990, c.02  ON THE PART OF THE RELEASEES, AND ALSO INCLUDING THE FAILURE ON THE PART OF THE RELEASEES TO SAFEGUARD OR PROTECT ME FROM THE RISKS, DANGERS AND HAZARDS REFERRED TO ABOVE;

       

      1. TO HOLD HARMLESS AND INDEMNIFY THE RELEASEES from any and all liability for any damage to property of or personal injury to any third party, resulting from my use of or presence on the BGCL facilities.

       

      I HAVE READ AND UNDERSTAND THIS AGREEMENT AND I AM AWARE THAT BY SIGNING THIS AGREEMENT I AM WAIVING CERTAIN LEGAL RIGHTS WHICH I OR MY HEIRS, NEXT OF KIN, EXECUTORS, ADMINISTRATORS, ASSIGNS AND REPRESENTATIVES MAY HAVE AGAINST THE RELEASEES.

       

      Signed {dateAnd}

    • Additional Permissions 
    • MEDIA CONSENT
      BGCL reserve the right and permission to publish, reproduce, distribute and/or otherwise use any still or moving photograph, for such purposes and with such frequency as it shall determine in its sole discretion without further compensation or consideration to me and without further authorization by me for, yet, unnamed video or photographic projects (including promotion, marketing and social media) which shall constitute the sole property of BGCL. BGCL shall be released from and against all liability resulting from its use of the photos or related to my use of the product.
    • I have read and understand the Photo Consent Release*
    • Date and Time Signed
       - -
  • PERMISSION TO SIGN OUT OF PROGRAM

    Some parents may choose to give their child permission to sign themselves out of program in order to walk home or leave with non-approved persons (friends, family, etc.). Please indicate below if your child has permission to sign themselves out:

  • You have indicated you do not wish your child to sign themselves out of programming. Please identify two approved adults who have permission to pick your child up from programming. These adults will be required to show Photo I.D. to staff onsite in order to release your child from programming.

  • Payment

  • *

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    BGC London Rural Hubs
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              BGC London Rural Hubs
              STEM Studio (Ages 8-12) - May 25-June 15 - General Fee


              $80.00 CAD$80.00CAD
                
              Pizza & Paint Night (Ages 8-12) - Tuesday, June 2, 2026 - General Fee
              $20.00 CAD$20.00CAD
                
              Mess Fest (Ages 4-7) - Tuesday, June 9, 2026 - General Fee
              $20.00 CAD$20.00CAD
                
              Tacos & Tie-Dye (Ages 8-12) - Tuesday, June 16, 2026 - General Fee
              $20.00 CAD$20.00CAD
                

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