Required fields are marked with asterisks (*)

Junior Inclusion Service Participant Intake Form

 

Support Suspended/Cancelled Policy

The Junior Inclusion Services (JIS) program, offered by the City of Thunder Bay, provides a valuable opportunity for children aged 5-18 with disabilities to actively engage in our programs. JIS ensures inclusive participation by offering personalized one-to-one support across various support needs.

In the event that a participants behaviour exceeds our staffing ability, support can be suspended or cancelled until a new plan is developed and in place to provide support in the safest way possible for both the staff and the participant. In these rare instances JIS staff will ensure they have exhausted all support strategies and will keep parent/guardians as up to date as possible. Some behaviours that may result in the cancellation of support are: repetitive aggression or violence towards Facilitators, program staff, oneself, or other participants, recurring events of eloping that raise safety concerns, changing personal care needs and participants that require 2:1 support to maintain safety. Acts of violence encompass behaviors such as biting, hitting, punching, kicking, spitting, pulling hair, throwing objects and other behaviours that put the safety of oneself or others at risk. It is our hope that support can be tailored to meet the needs of your child and we look forward to working with you to make that happen!

Should you have any inquiries or concerns, please feel free to contact us at jis@thunderbay.ca. We are here to assist you.

Gender:
 

If we need to contact you and are unable to reach you at the above numbers, please provide the name and phone number of an alternate contact during program hours:

Does your child/youth use any assistive devices(e.g. wheelchair)?
 

SUPPORTS

Your child:
 

PROGRAM CHOICES

Your child is interested in:

JANUARY TO JUNE, & SEPTEMBER TO DECEMBER
 
JULY TO AUGUST
 
Will you be using ProKids?
 
Photo Consent: Junior Inclusion Services keeps a photo of each participant in our participant files. Please indicate if you wish to have your picture taken for your file.
 
How did you find out about Junior Inclusion Services?
 



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