Event Registration Form
  • Please fill in "Father's Day"
    Please let us know your choice of time you would like to attend the drive through.
  • Who will be attending the event?
    Limited availability - Please let us know if you need transportation and we will do our best to accomodate
    Full permission is granted to Chai Lifeline Canada and it’s representatives to photograph any child/teen, and to use, publish, and release for publication any photos taken at this event.
  • Use computer mouse or finger to sign
  • Please type the first and last name of person who signed
  • Date Format: DD slash MM slash YYYY