Online After-School Program Application

To apply for an LDANR program, please complete the following steps:

• Fully complete Steps 1-8 of the Program Application Form and click submit (please note: you cannot save).
• Submit supporting documents. The application is NOT CONSIDERED COMPLETE until your child's most recent report card/progress report has been received. Supporting documentation may include:
  - most recent report card OR progress report (*required);
  - Individual Education Plan (*required, if applicable);
  - Assessments (if applicable);
  - Teacher Feedback Form (if possible - Click Here for the Teacher Feedback Form);
  - Any additional information that you feel may be useful in determining your child's needs for the program.
• Following screening, accepted applicants will be notified closer to the program start date.
• Following acceptance, program payment will be required. This will be outlined in the acceptance email. Subsidy and payment plans may be available.

Please note: This information will be kept strictly confidential. It will only be shared with LDANR staff and volunteers who will be working with the children.

LDANR programs are designed for individuals with learning disabilities, not other exceptionalities. If unsure of eligibility, contact the office prior to completing the form at info@Ldaniagara.org.

1. I hereby authorize the administration of any and all emergency medical attention that my child might require as a result of injury or sickness while attending LDANR programs.
2. I hereby agree to comply with the LDANR's policy on anti-discrimination, violence and harassment. This is with the understanding that non-compliance may result in my removal from LDANR programming, thereby requiring a designate to pick-up and drop-off my child.
3. I hereby release the LDANR, its directors, staff, agents and members from any loss, personal injury, accident, misfortune or damage to the above-named or his/her property, with the understanding that reasonable precautions shall be taken to ensure the health and safety of the above-named participant.
4. I understand that the information collected on this form will only be used to assess my child's eligibility for programming, to make the LDANR aware of any medical or allergy concerns for my child, and to ensure safe pick-up and drop-off of my child. This information will only be shared with LDANR staff and volunteers.
5. I understand that for the program to be effective, and out of respect for the program volunteers and those who did not get a spot in the program, LDANR requests that families commit to attending each session of the program. If attendance is irregular or too many sessions have been missed the participant will be asked to leave the program to open the spot up to another participant.
6. I understand that for the safety of the volunteer staff and other participants, LDANR has the right and responsibility to take actions such as phone calls home and possible dismissal from program if a child exhibits continual inappropriate behaviour.
7. I understand that the LDANR charges a fee for our programs, which must be paid prior to the program start date. For more information on program fees, please visit the program-specific pages on the LDANR website. If families require financial aid to access the program, families may apply for subsidy by filling out a Program Subsidy Application Form.
8. I understand that for a program to run, enough eligible participants have to apply for the program. If there is low enrolment, the LDANR has the right to cancel any program at any time.
9. I understand that, if the LDANR must cancel a program date due to circumstances outside of their control (e.g., inclement weather), no refunds will be issued. The LDANR will make an effort to reschedule the cancelled session where possible, but there is no guarantee that a cancelled session will be made up.
10. I understand that data is collected from LDANR programs to be used when reporting to funders/sponsors. All information used for reporting purposes is kept confidential and only used by LDANR staff. Participant names are removed and participant data is kept anonymous. Possible data sources used for reporting purposes include test scores, pre and post tests, ages, type of LD diagnosis. If you do not wish for your child's assessment data to be used for research purposes, please make note in the comment section below, or contact the LDANR office.
11. I understand that any online programming will take place through a third-party, web-based learning platform. LDANR will not be held liable in the event of a privacy or security breach related to the third-party.

Payment instructions:

Prior to making any payments, please wait to receive notice of your child's acceptance into the program you've applied for. With the temporary closure of the LDANR's physical office due to COVID-19, only payments made via PayPal will be accepted.

Cancellation policy:

Cancellations must be made at least one week prior to program start in order to receive a partial refund (an administration fee may apply). Please note that membership payments cannot be refunded.