
After School Program - Trial Form
CHILD & PROGRAM INFORMATION:
Note: The Children on the previous page are the children associated with your profile. If you are not registering all of the listed children in the After School Program, please hit the 'Back' button above and remove the children that you are not registering. This will remove the children from the form, but will not remove them from your profile. |
*Please select the week you would like your child to participate in the free trial:
(Note: weeks are Monday - Friday)
*Please select the school that the student will be attending for the 2020-2021 school year.
If applicable, please select the location of your choice.
School
|
MAX Location |
Admiral's Academy |
All Saints Parish Hall, CBS West |
Bishop Field Elementary |
34 New Cove Road, St. John's |
Elizabeth Park Elementary |
Kenmount Terrace Community Centre |
Goulds Elementary |
Southlands Community Centre |
Holy Family Elementary |
St. Thomas Line Community Center (Subject to change) |
Holy Trinity Elementary |
Torbay Community Center |
Juniper Ridge Intermediate |
Torbay Community Center |
Larkhall Academy |
34 New Cove Road, St. John's |
Kenmount Terrace Community Centre |
MacDonald Drive Elementary |
34 New Cove Road, St. John's |
Mary Queen of Peace |
34 Cove Road, St. John's |
Mary Queen of the World |
Salvation Army, Mount Pearl |
Southlands Community Center |
Morris Academy |
Southlands Community Center |
Newtown Elementary |
Southlands Community Center |
Octagon Pond Elementary |
St. Thomas Line Community Center (Subject to change) |
Paradise Elementary |
Kenmount Terrace Community Centre |
Rennie's River Elementary |
34 New Cove Road, St. John's |
Roncalli Elementary |
34 New Cove Road, St. John's |
St. Edward's Elementary |
All Saints Parish Hall, CBS West |
St. Francis of Assisi |
34 New Cove Road, St. John's |
St. Peter's Primary |
Salvation Army, Mount Pearl |
Southlands Community Center
(Select only if older sibling attends Newtown Elementary) |
Topsail Elementary |
St. Thomas of Villa Nova Parish Hall, CBS East |
Vanier Elementary |
34 New Cove Road, St. John's |
Villanova Junior High |
St Thomas of Villa Nova Parish Hall, CBS East |
MEDICAL INFORMATION
*Does the student have any medical (including food and other allergies), physical, or behavioural concerns that our staff should be aware of? (CONFIDENTIAL)
If this section does not apply, please type N/A into the text box.
*Does the student require any medication to be administered? (CONFIDENTIAL)
Yes No
If yes, the following section is required to be completed:
*Please select the week you would like your child to participate in the free trial:
(Note: weeks are Monday - Friday)
*Please select the school that the student will be attending for the 2020-2021 school year.
If applicable, please select the location of your choice.
School
|
MAX Location |
Admiral's Academy |
All Saints Parish Hall, CBS West |
Bishop Field Elementary |
34 New Cove Road, St. John's |
Elizabeth Park Elementary |
Kenmount Terrace Community Centre |
Goulds Elementary |
Southlands Community Centre |
Holy Family Elementary |
St. Thomas Line Community Center (Subject to change) |
Holy Trinity Elementary |
Torbay Community Center |
Juniper Ridge Intermediate |
Torbay Community Center |
Larkhall Academy |
34 New Cove Road, St. John's |
Kenmount Terrace Community Centre |
MacDonald Drive Elementary |
34 New Cove Road, St. John's |
Mary Queen of Peace |
34 Cove Road, St. John's |
Mary Queen of the World |
Salvation Army, Mount Pearl |
Southlands Community Center |
Morris Academy |
Southlands Community Center |
Newtown Elementary |
Southlands Community Center |
Octagon Pond Elementary |
St. Thomas Line Community Center (Subject to change) |
Paradise Elementary |
Kenmount Terrace Community Centre |
Rennie's River Elementary |
34 New Cove Road, St. John's |
Roncalli Elementary |
34 New Cove Road, St. John's |
St. Edward's Elementary |
All Saints Parish Hall, CBS West |
St. Francis of Assisi |
34 New Cove Road, St. John's |
St. Peter's Primary |
Salvation Army, Mount Pearl |
Southlands Community Center
(Select only if older sibling attends Newtown Elementary) |
Topsail Elementary |
St. Thomas of Villa Nova Parish Hall, CBS East |
Vanier Elementary |
34 New Cove Road, St. John's |
Villanova Junior High |
St Thomas of Villa Nova Parish Hall, CBS East |
MEDICAL INFORMATION
*Does the student have any medical (including food and other allergies), physical, or behavioural concerns that our staff should be aware of? (CONFIDENTIAL)
If this section does not apply, please type N/A into the text box.
*Does the student require any medication to be administered? (CONFIDENTIAL)
Yes No
If yes, the following section is required to be completed:
*Please select the week you would like your child to participate in the free trial:
(Note: weeks are Monday - Friday)
*Please select the school that the student will be attending for the 2020-2021 school year.
If applicable, please select the location of your choice.
School
|
MAX Location |
Admiral's Academy |
All Saints Parish Hall, CBS West |
Bishop Field Elementary |
34 New Cove Road, St. John's |
Elizabeth Park Elementary |
Kenmount Terrace Community Centre |
Goulds Elementary |
Southlands Community Centre |
Holy Family Elementary |
St. Thomas Line Community Center (Subject to change) |
Holy Trinity Elementary |
Torbay Community Center |
Juniper Ridge Intermediate |
Torbay Community Center |
Larkhall Academy |
34 New Cove Road, St. John's |
Kenmount Terrace Community Centre |
MacDonald Drive Elementary |
34 New Cove Road, St. John's |
Mary Queen of Peace |
34 Cove Road, St. John's |
Mary Queen of the World |
Salvation Army, Mount Pearl |
Southlands Community Center |
Morris Academy |
Southlands Community Center |
Newtown Elementary |
Southlands Community Center |
Octagon Pond Elementary |
St. Thomas Line Community Center (Subject to change) |
Paradise Elementary |
Kenmount Terrace Community Centre |
Rennie's River Elementary |
34 New Cove Road, St. John's |
Roncalli Elementary |
34 New Cove Road, St. John's |
St. Edward's Elementary |
All Saints Parish Hall, CBS West |
St. Francis of Assisi |
34 New Cove Road, St. John's |
St. Peter's Primary |
Salvation Army, Mount Pearl |
Southlands Community Center
(Select only if older sibling attends Newtown Elementary) |
Topsail Elementary |
St. Thomas of Villa Nova Parish Hall, CBS East |
Vanier Elementary |
34 New Cove Road, St. John's |
Villanova Junior High |
St Thomas of Villa Nova Parish Hall, CBS East |
MEDICAL INFORMATION
*Does the student have any medical (including food and other allergies), physical, or behavioural concerns that our staff should be aware of? (CONFIDENTIAL)
If this section does not apply, please type N/A into the text box.
*Does the student require any medication to be administered? (CONFIDENTIAL)
Yes No
If yes, the following section is required to be completed:
*Please select the week you would like your child to participate in the free trial:
(Note: weeks are Monday - Friday)
*Please select the school that the student will be attending for the 2020-2021 school year.
If applicable, please select the location of your choice.
School
|
MAX Location |
Admiral's Academy |
All Saints Parish Hall, CBS West |
Bishop Field Elementary |
34 New Cove Road, St. John's |
Elizabeth Park Elementary |
Kenmount Terrace Community Centre |
Goulds Elementary |
Southlands Community Centre |
Holy Family Elementary |
St. Thomas Line Community Center (Subject to change) |
Holy Trinity Elementary |
Torbay Community Center |
Juniper Ridge Intermediate |
Torbay Community Center |
Larkhall Academy |
34 New Cove Road, St. John's |
Kenmount Terrace Community Centre |
MacDonald Drive Elementary |
34 New Cove Road, St. John's |
Mary Queen of Peace |
34 Cove Road, St. John's |
Mary Queen of the World |
Salvation Army, Mount Pearl |
Southlands Community Center |
Morris Academy |
Southlands Community Center |
Newtown Elementary |
Southlands Community Center |
Octagon Pond Elementary |
St. Thomas Line Community Center (Subject to change) |
Paradise Elementary |
Kenmount Terrace Community Centre |
Rennie's River Elementary |
34 New Cove Road, St. John's |
Roncalli Elementary |
34 New Cove Road, St. John's |
St. Edward's Elementary |
All Saints Parish Hall, CBS West |
St. Francis of Assisi |
34 New Cove Road, St. John's |
St. Peter's Primary |
Salvation Army, Mount Pearl |
Southlands Community Center
(Select only if older sibling attends Newtown Elementary) |
Topsail Elementary |
St. Thomas of Villa Nova Parish Hall, CBS East |
Vanier Elementary |
34 New Cove Road, St. John's |
Villanova Junior High |
St Thomas of Villa Nova Parish Hall, CBS East |
MEDICAL INFORMATION
*Does the student have any medical (including food and other allergies), physical, or behavioural concerns that our staff should be aware of? (CONFIDENTIAL)
If this section does not apply, please type N/A into the text box.
*Does the student require any medication to be administered? (CONFIDENTIAL)
Yes No
If yes, the following section is required to be completed:
*Please select the week you would like your child to participate in the free trial:
(Note: weeks are Monday - Friday)
*Please select the school that the student will be attending for the 2020-2021 school year.
If applicable, please select the location of your choice.
School
|
MAX Location |
Admiral's Academy |
All Saints Parish Hall, CBS West |
Bishop Field Elementary |
34 New Cove Road, St. John's |
Elizabeth Park Elementary |
Kenmount Terrace Community Centre |
Goulds Elementary |
Southlands Community Centre |
Holy Family Elementary |
St. Thomas Line Community Center (Subject to change) |
Holy Trinity Elementary |
Torbay Community Center |
Juniper Ridge Intermediate |
Torbay Community Center |
Larkhall Academy |
34 New Cove Road, St. John's |
Kenmount Terrace Community Centre |
MacDonald Drive Elementary |
34 New Cove Road, St. John's |
Mary Queen of Peace |
34 Cove Road, St. John's |
Mary Queen of the World |
Salvation Army, Mount Pearl |
Southlands Community Center |
Morris Academy |
Southlands Community Center |
Newtown Elementary |
Southlands Community Center |
Octagon Pond Elementary |
St. Thomas Line Community Center (Subject to change) |
Paradise Elementary |
Kenmount Terrace Community Centre |
Rennie's River Elementary |
34 New Cove Road, St. John's |
Roncalli Elementary |
34 New Cove Road, St. John's |
St. Edward's Elementary |
All Saints Parish Hall, CBS West |
St. Francis of Assisi |
34 New Cove Road, St. John's |
St. Peter's Primary |
Salvation Army, Mount Pearl |
Southlands Community Center
(Select only if older sibling attends Newtown Elementary) |
Topsail Elementary |
St. Thomas of Villa Nova Parish Hall, CBS East |
Vanier Elementary |
34 New Cove Road, St. John's |
Villanova Junior High |
St Thomas of Villa Nova Parish Hall, CBS East |
MEDICAL INFORMATION
*Does the student have any medical (including food and other allergies), physical, or behavioural concerns that our staff should be aware of? (CONFIDENTIAL)
If this section does not apply, please type N/A into the text box.
*Does the student require any medication to be administered? (CONFIDENTIAL)
Yes No
If yes, the following section is required to be completed:
*Please select the week you would like your child to participate in the free trial:
(Note: weeks are Monday - Friday)
*Please select the school that the student will be attending for the 2020-2021 school year.
If applicable, please select the location of your choice.
School
|
MAX Location |
Admiral's Academy |
All Saints Parish Hall, CBS West |
Bishop Field Elementary |
34 New Cove Road, St. John's |
Elizabeth Park Elementary |
Kenmount Terrace Community Centre |
Goulds Elementary |
Southlands Community Centre |
Holy Family Elementary |
St. Thomas Line Community Center (Subject to change) |
Holy Trinity Elementary |
Torbay Community Center |
Juniper Ridge Intermediate |
Torbay Community Center |
Larkhall Academy |
34 New Cove Road, St. John's |
Kenmount Terrace Community Centre |
MacDonald Drive Elementary |
34 New Cove Road, St. John's |
Mary Queen of Peace |
34 Cove Road, St. John's |
Mary Queen of the World |
Salvation Army, Mount Pearl |
Southlands Community Center |
Morris Academy |
Southlands Community Center |
Newtown Elementary |
Southlands Community Center |
Octagon Pond Elementary |
St. Thomas Line Community Center (Subject to change) |
Paradise Elementary |
Kenmount Terrace Community Centre |
Rennie's River Elementary |
34 New Cove Road, St. John's |
Roncalli Elementary |
34 New Cove Road, St. John's |
St. Edward's Elementary |
All Saints Parish Hall, CBS West |
St. Francis of Assisi |
34 New Cove Road, St. John's |
St. Peter's Primary |
Salvation Army, Mount Pearl |
Southlands Community Center
(Select only if older sibling attends Newtown Elementary) |
Topsail Elementary |
St. Thomas of Villa Nova Parish Hall, CBS East |
Vanier Elementary |
34 New Cove Road, St. John's |
Villanova Junior High |
St Thomas of Villa Nova Parish Hall, CBS East |
MEDICAL INFORMATION
*Does the student have any medical (including food and other allergies), physical, or behavioural concerns that our staff should be aware of? (CONFIDENTIAL)
If this section does not apply, please type N/A into the text box.
*Does the student require any medication to be administered? (CONFIDENTIAL)
Yes No
If yes, the following section is required to be completed:
*Please select the week you would like your child to participate in the free trial:
(Note: weeks are Monday - Friday)
*Please select the school that the student will be attending for the 2020-2021 school year.
If applicable, please select the location of your choice.
School
|
MAX Location |
Admiral's Academy |
All Saints Parish Hall, CBS West |
Bishop Field Elementary |
34 New Cove Road, St. John's |
Elizabeth Park Elementary |
Kenmount Terrace Community Centre |
Goulds Elementary |
Southlands Community Centre |
Holy Family Elementary |
St. Thomas Line Community Center (Subject to change) |
Holy Trinity Elementary |
Torbay Community Center |
Juniper Ridge Intermediate |
Torbay Community Center |
Larkhall Academy |
34 New Cove Road, St. John's |
Kenmount Terrace Community Centre |
MacDonald Drive Elementary |
34 New Cove Road, St. John's |
Mary Queen of Peace |
34 Cove Road, St. John's |
Mary Queen of the World |
Salvation Army, Mount Pearl |
Southlands Community Center |
Morris Academy |
Southlands Community Center |
Newtown Elementary |
Southlands Community Center |
Octagon Pond Elementary |
St. Thomas Line Community Center (Subject to change) |
Paradise Elementary |
Kenmount Terrace Community Centre |
Rennie's River Elementary |
34 New Cove Road, St. John's |
Roncalli Elementary |
34 New Cove Road, St. John's |
St. Edward's Elementary |
All Saints Parish Hall, CBS West |
St. Francis of Assisi |
34 New Cove Road, St. John's |
St. Peter's Primary |
Salvation Army, Mount Pearl |
Southlands Community Center
(Select only if older sibling attends Newtown Elementary) |
Topsail Elementary |
St. Thomas of Villa Nova Parish Hall, CBS East |
Vanier Elementary |
34 New Cove Road, St. John's |
Villanova Junior High |
St Thomas of Villa Nova Parish Hall, CBS East |
MEDICAL INFORMATION
*Does the student have any medical (including food and other allergies), physical, or behavioural concerns that our staff should be aware of? (CONFIDENTIAL)
If this section does not apply, please type N/A into the text box.
*Does the student require any medication to be administered? (CONFIDENTIAL)
Yes No
If yes, the following section is required to be completed:
*Please select the week you would like your child to participate in the free trial:
(Note: weeks are Monday - Friday)
*Please select the school that the student will be attending for the 2020-2021 school year.
If applicable, please select the location of your choice.
School
|
MAX Location |
Admiral's Academy |
All Saints Parish Hall, CBS West |
Bishop Field Elementary |
34 New Cove Road, St. John's |
Elizabeth Park Elementary |
Kenmount Terrace Community Centre |
Goulds Elementary |
Southlands Community Centre |
Holy Family Elementary |
St. Thomas Line Community Center (Subject to change) |
Holy Trinity Elementary |
Torbay Community Center |
Juniper Ridge Intermediate |
Torbay Community Center |
Larkhall Academy |
34 New Cove Road, St. John's |
Kenmount Terrace Community Centre |
MacDonald Drive Elementary |
34 New Cove Road, St. John's |
Mary Queen of Peace |
34 Cove Road, St. John's |
Mary Queen of the World |
Salvation Army, Mount Pearl |
Southlands Community Center |
Morris Academy |
Southlands Community Center |
Newtown Elementary |
Southlands Community Center |
Octagon Pond Elementary |
St. Thomas Line Community Center (Subject to change) |
Paradise Elementary |
Kenmount Terrace Community Centre |
Rennie's River Elementary |
34 New Cove Road, St. John's |
Roncalli Elementary |
34 New Cove Road, St. John's |
St. Edward's Elementary |
All Saints Parish Hall, CBS West |
St. Francis of Assisi |
34 New Cove Road, St. John's |
St. Peter's Primary |
Salvation Army, Mount Pearl |
Southlands Community Center
(Select only if older sibling attends Newtown Elementary) |
Topsail Elementary |
St. Thomas of Villa Nova Parish Hall, CBS East |
Vanier Elementary |
34 New Cove Road, St. John's |
Villanova Junior High |
St Thomas of Villa Nova Parish Hall, CBS East |
MEDICAL INFORMATION
*Does the student have any medical (including food and other allergies), physical, or behavioural concerns that our staff should be aware of? (CONFIDENTIAL)
If this section does not apply, please type N/A into the text box.
*Does the student require any medication to be administered? (CONFIDENTIAL)
Yes No
If yes, the following section is required to be completed:
*Please select the week you would like your child to participate in the free trial:
(Note: weeks are Monday - Friday)
*Please select the school that the student will be attending for the 2020-2021 school year.
If applicable, please select the location of your choice.
School
|
MAX Location |
Admiral's Academy |
All Saints Parish Hall, CBS West |
Bishop Field Elementary |
34 New Cove Road, St. John's |
Elizabeth Park Elementary |
Kenmount Terrace Community Centre |
Goulds Elementary |
Southlands Community Centre |
Holy Family Elementary |
St. Thomas Line Community Center (Subject to change) |
Holy Trinity Elementary |
Torbay Community Center |
Juniper Ridge Intermediate |
Torbay Community Center |
Larkhall Academy |
34 New Cove Road, St. John's |
Kenmount Terrace Community Centre |
MacDonald Drive Elementary |
34 New Cove Road, St. John's |
Mary Queen of Peace |
34 Cove Road, St. John's |
Mary Queen of the World |
Salvation Army, Mount Pearl |
Southlands Community Center |
Morris Academy |
Southlands Community Center |
Newtown Elementary |
Southlands Community Center |
Octagon Pond Elementary |
St. Thomas Line Community Center (Subject to change) |
Paradise Elementary |
Kenmount Terrace Community Centre |
Rennie's River Elementary |
34 New Cove Road, St. John's |
Roncalli Elementary |
34 New Cove Road, St. John's |
St. Edward's Elementary |
All Saints Parish Hall, CBS West |
St. Francis of Assisi |
34 New Cove Road, St. John's |
St. Peter's Primary |
Salvation Army, Mount Pearl |
Southlands Community Center
(Select only if older sibling attends Newtown Elementary) |
Topsail Elementary |
St. Thomas of Villa Nova Parish Hall, CBS East |
Vanier Elementary |
34 New Cove Road, St. John's |
Villanova Junior High |
St Thomas of Villa Nova Parish Hall, CBS East |
MEDICAL INFORMATION
*Does the student have any medical (including food and other allergies), physical, or behavioural concerns that our staff should be aware of? (CONFIDENTIAL)
If this section does not apply, please type N/A into the text box.
*Does the student require any medication to be administered? (CONFIDENTIAL)
Yes No
If yes, the following section is required to be completed:
*Please select the week you would like your child to participate in the free trial:
(Note: weeks are Monday - Friday)
*Please select the school that the student will be attending for the 2020-2021 school year.
If applicable, please select the location of your choice.
School
|
MAX Location |
Admiral's Academy |
All Saints Parish Hall, CBS West |
Bishop Field Elementary |
34 New Cove Road, St. John's |
Elizabeth Park Elementary |
Kenmount Terrace Community Centre |
Goulds Elementary |
Southlands Community Centre |
Holy Family Elementary |
St. Thomas Line Community Center (Subject to change) |
Holy Trinity Elementary |
Torbay Community Center |
Juniper Ridge Intermediate |
Torbay Community Center |
Larkhall Academy |
34 New Cove Road, St. John's |
Kenmount Terrace Community Centre |
MacDonald Drive Elementary |
34 New Cove Road, St. John's |
Mary Queen of Peace |
34 Cove Road, St. John's |
Mary Queen of the World |
Salvation Army, Mount Pearl |
Southlands Community Center |
Morris Academy |
Southlands Community Center |
Newtown Elementary |
Southlands Community Center |
Octagon Pond Elementary |
St. Thomas Line Community Center (Subject to change) |
Paradise Elementary |
Kenmount Terrace Community Centre |
Rennie's River Elementary |
34 New Cove Road, St. John's |
Roncalli Elementary |
34 New Cove Road, St. John's |
St. Edward's Elementary |
All Saints Parish Hall, CBS West |
St. Francis of Assisi |
34 New Cove Road, St. John's |
St. Peter's Primary |
Salvation Army, Mount Pearl |
Southlands Community Center
(Select only if older sibling attends Newtown Elementary) |
Topsail Elementary |
St. Thomas of Villa Nova Parish Hall, CBS East |
Vanier Elementary |
34 New Cove Road, St. John's |
Villanova Junior High |
St Thomas of Villa Nova Parish Hall, CBS East |
MEDICAL INFORMATION
*Does the student have any medical (including food and other allergies), physical, or behavioural concerns that our staff should be aware of? (CONFIDENTIAL)
If this section does not apply, please type N/A into the text box.
*Does the student require any medication to be administered? (CONFIDENTIAL)
Yes No
If yes, the following section is required to be completed:
PARENT/GUARDIAN INFORMATION
PERSONS OTHER THAN PARENTS/GUARDIANS LISTED ABOVE WHO ARE PERMITTED TO PICK THE CHILD UP FROM MAX:
Please note that each person must be 18 years of age or older and may be required to show picture identification before the child is released to him or her.
Any persons not listed here will not be permitted access to the child.
1. Name:
2. Name:
3. Name:
Terms & Conditions for 2020-2021 After School Free Trial
- All of the student’s relevant illnesses, medical conditions, disabilities, and/or behavioral concerns have been disclosed to MAX on the registration form.
- Students will not be able to partake in programs if their MCP number is not on file. You hereby give MAX and its employees the authority to act on your behalf in case of any emergency. If, due to such circumstances as injury or sudden illness, medical treatment is necessary, you authorize MAX to take whatever emergency measures are deemed necessary by MAX for the protection of the student while in the care of MAX. You understand that this may involve calling a physician, interpreting and carrying out his or her instructions, and transporting the student to a hospital, including the possible use of an ambulance. This could also include emergency transportation required as a result of fire or other environmental emergencies. You understand that this may be done prior to contacting you, and that any expense incurred for such treatment, including ambulance fees, is your responsibility.
- MAX promotes an atmosphere of safety and mutual respect and will not tolerate inappropriate conduct or behavior. Violation of these principles may result in immediate termination of the student’s enrollment.
- In consideration of being allowed to participate in MAX activities and programs and to use MAX facilities, equipment and services, you hereby forever waive, release and discharge MAX and its officers, agents, employees, representatives, executors and all others acting on their behalf from any and all claims or liabilities for injuries or damages to the student’s person and/or property, including those caused by the negligent act or omission of any of sparing those mentioned or others acting on their behalf, arising out of or connected with the participation in any activities, programs or services of MAX or the use of any equipment at various sites, including home, provided by and/or recommended by a MAX representative.
- MAX takes customer privacy seriously. We will not sell, distribute, barter or transfer any personally identifiable information obtained about our students to parties outside of MAX, without the authorized written consent of the student or the parent(s)/guardian(s) if the student is under the age of 18 (except where required by law such as in emergency situations or by legal order). In the normal course of business and for the purpose of advertising, MAX may photograph or video students as they partake in MAX activities. Such photographs or videos may be used by MAX for publicity purposes without the student’s name attached unless the student or the parent(s)/guardian(s) if the student is under the age of 18 otherwise advises MAX in writing. No photography or video is permitted to be taken inside any MAX location without the express written consent of MAX.
ACCEPTANCE: By signing below, I acknowledge and agree to the Terms and Conditions written above and I represent that the information given by me on the Free Trial Registration Form is complete and accurate.
Other Comments:
Parent/Guardian Signature Below: