Registration for Yannick Bergeron-The chemist
Please fill out ONE form PER CHILD.
Are you a member? If you are not, don't forget to pay the $10.00 to participate.
Parent/ guardian informations
Phone number :
E-mail address :
Indicate if both parents will be present:
I want my child to participate in the children's show Yannick Bergeron the chemist :
I authorize The Centre culturel La Ronde to take photos of my child(ren) and share them on Facebook/website :
Signature of parent/ guardian :