Mulberry Meadows Community Hub
Fall 2026 Program Registration - LeadHERship Thursdays 6:30-8:30pm Oct 8-Dec 10. For ages 10-12. Location: 99 Barnham St Ajax
Family Information
Parent/Guardian Name
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First Name
Last Name
Parent/Guardian Email Address
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Parent/Guardian Phone Number
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Please enter a valid phone number.
Format: (000) 000-0000.
Parent/Guardian Address
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Street Address
Street Address Line 2
City
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Emergency Contact Name
First Name
Last Name
Emergency Contact Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
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Participant's Information
Participant's Name
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First Name
Last Name
Participant's Date of Birth
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Does the participant have any medical conditions we need to be aware of?
Does the participant have any dietary restrictions or food allergies
Does the participant carry an auto injector for an allergy
*
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No
Does the participant carry an inhaler
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LeadHERship
Ages 10-12, Thursdays 6:30 - 8:30pm, Oct 8 - Dec 10
Program Confirmation
*
LeadHERship, Oct 8 - Dec 10, 6:30-8:30pm, Ages 10-12
Payment
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LeadHERship
Fall 2026 Session Oct 8 - Dec 10
$150.00 CAD
$
150.00
CAD
Payment Methods
Credit Card
Apple Pay
After submitting the form, you will be redirected to Apple Pay to complete the payment.
Google Pay
After submitting the form, you will be redirected to Google Pay to complete the payment.
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