Registration

There are 3 easy steps to register:

1. Complete the registration form below.
2. The Festival and Volunteer Coordinator will confirm your registration within 2 weeks.
3. Once confirmed, send cheque payable to “Conservation Halton" by September 21, 2012 to:
   
   Beth Anne Fischer
   Halton Children's Water Festival Coordinator
   Conservation Halton
   2596 Britannia Road West
   Burlington, ON
   L7P 0G3

Please note:

• There are no refunds or credits for this event.

• To finalize your registration, all 3 steps must be completed. As spaces are limited, registration will be handled on a first-come-first-serve basis, so be sure to reserve your space soon!

• Should your number of students change by more than 5 per grade please provide the revised numbers to the Halton Children's Water Festival Coordinator no later than September 11, 2012. The amount you'll be charged will be based on the number you provide as of September 11, 2012.

• As part of the $5 per student fee, bussing is arranged and paid for by the Halton Children’s Water Festival.

* required field

Main Contact Person

Name	*
E-mail address	*
Phone Number	*

School Information

Name	*
Board	*** Select School Board *** Halton Catholic District School Board Halton District School Board Private school Other
Address	*
City	*
Postal Code	*
Phone	*
Fax
Select all grades attending and fill out details below.	Grade 2     Grade 4
	Grade 3     Grade 5
Grade 2 Teacher's Name   Teacher's E-Mail   Number of Students   Number of Adult Supervisors   Grade 3 Teacher's Name   Teacher's E-Mail   Number of Students   Number of Adult Supervisors   Grade 4 Teacher's Name   Teacher's E-Mail   Number of Students   Number of Adult Supervisors   Grade 5 Teacher's Name   Teacher's E-Mail   Number of Students   Number of Adult Supervisors
Total Cost ($5 x # of students) No cost to teachers or volunteers.	$
Special Needs & Emergency Medical Information

Preferential Date(s) of visit

Please tell us which dates (maximum three) you would prefer to attend the Festival. Enter 1 for your first choice, 2 for your second choice, 3 for your third choice and 4 for your fourth choice, using the box next to the dates below.
Tuesday, September 25	*
Wednesday, September 26	*
Thursday, September 27	*
Friday, September 28	*

French Immersion Day

The HCWF is piloting a French language day for GRADE FIVE students on Thursday, September 27. Half of the grade five activities will be run by Grade 11, French immersion students, who will present the activities in French. Please check this box if you prefer the Grade Five French Immersion day. NOTE: The grade five French option is available Thursday, September 27, 2012 only.
Thursday, September 27 - French Immersion	*

Advertising

How did you hear about the 2012 Festival? (check all that apply)
Website
From a colleague (ie: teacher, principal)
Newspaper
Information package
E-mail Notification
Other

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