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Registration for Take Our Kids to Work Day

Gender:  Male Female Other
Grade 9 student:  Yes

Note: unfortunately the building is not accessible at this time.

School Name:
School Location: Burlington Oakville Milton Other:
Lunch: please advise if there are any food allergies or dietary requirements:
Parent's name:
Parent's cell/tel.: Parent's email address:
Student's cell: Student's email address:
Emergency contact:  Same as above Other
If other:
Name: Relationship to student:
Cell/tel.: Email address:


The Centre for Skills Development & Training is not liable for damages arising from any and all actions, claims, demands, obligations, causes of actions, costs, expenses and compensation of any kind on account of or in any way arising out of, or which in the future may result from, participation in Take Our Kids to Work Day or in conjunction with Take Our Kids to Work Day or the negligence of other people, including other participants.

 I agree to the terms above.

Permission to photograph:

I HEREBY grant to “The Centre” and those authorized on its behalf, including its official and non-officialcpartners the right to photograph, record on film, videotape, audiotape, other audiovisual or written format, my voice, person, or other material produced by me related to “The Centre”, and grant also the nonexclusive right, license and privilege under copyright, or other right or license enjoyed by me to use, broadcast, cablecast, reproduce, print, publish and distribute the above in any format for educational and promotional purposes, worldwide in perpetuity.

I warrant and represent that the rights granted herein, and the use thereof will in no way infringe or violate any trade mark patent, trade name, or copyright of any person, and I hereby release “The Centre” and its partners from all actions, claims and demands arising from the above grant, except those arising from “The Centre’s” negligence; and agree to indemnify and save “The Centre” harmless from all claims, costs, charges, damages and expenses arising from the breach of the above warrant.

 I agree to the terms above and that my child can be photographed.

Personal information on this form is collected pursuant to the Municipal Act, 2001, S.O. 2001, c. 25, and will only be used for the purposes identified above. Questions about the collection of your information can be addressed to the Manager, Marketing & Communications, 3350 South Service Road, Burlington, Ontario L7N 3M6 or email:

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