Avalon Office: 2019/2020 Program Application

Please Read Carefully

A confirmation email will be sent once the registration form is submitted. If you do not receive the confirmation email please submit the registration form again.

If this page remains after you submit your form please scroll down and fill out anything you may have missed then resubmit.


Please Note

If the cost of programs are a barrier to participation for your family please contact Chief Operations Officer ,Tess Hemeon at, themeon@autism.nf.net

To apply for programs, you must have all outstanding program fees are paid in full and the 2019/20 Membership (due April 1, 2019) updated.  Click HERE to update your membership now.

ASNL accepts and/or declines applicants on the basis of specific selection criteria for each program. ASNL may choose to withdraw any participant’s participation in a program if/when there are emerging safety concerns.


2019/2020 Program Application

  • Contact Information

  • Date Format: YYYY dash MM dash DD
  • Please note important information regarding programming will be sent to this email address
  • Guardian 1

  • Guardian 2

  • Emergency Contact/Alternative Pick-up person

    Other than above.
  • Please note it is the guardian’s responsibility to ensure ASNL has accurate information on file to meet the programming needs of the participant and the organization.
  • Additional Information

    *an additional form will be completed upon applying.
  • Sensory Sensitivities/Considerations

  • POLICIES AND PROCEDURES


    AUTISM SOCIETY, NL OFFERS QUALITY PROGRAM OPPORTUNITIES FOR INDIVIDUALS WITH ASD AND THEIR FAMILIES.

    TO ENSURE A SAFE AND SUCCESSFUL ENVIRONMENT FOR PROGRAM PARTICIPANTS AND STAFF, IT IS IMPORTANT THAT CAREGIVERS AND PARTICIPANTS UNDERSTAND AND ADHERE TO THE PROCEDURES OUTLINED BELOW.
  • Drop-off and Pick-up


    • Participants in programming will be in session during the designated times only (i.e. 1:00 – 2:00 PM).

    • If a caregiver is unable to pick up the participant, alternative arrangements are to be made and staff advised accordingly.

    • Repeated late pick-ups will result in a meeting and subsequent late pick-ups will be addressed appropriately at the discretion of the Chief Executive Officer.

    • There are no supervised waiting areas available for participants to stay before or after the designated program time.
  • Attendance


    • Any absences from scheduled programming should be communicated with staff as early as possible.

    • Three consecutive absences without prior notification may result in an withdrawal from the program (with an opportunity to re-register the following semester)..
  • Payment of Invoices


    • It is the responsibility of caregivers to ensure invoices are fully paid before the program begins.

    • If a participant chooses to withdraw from programming, the caregiver is still responsible to pay the invoice in full.

    • If ASNL cancels a centre based program session a credit for $15 will be applied to the participants account..

    • Outstanding invoices must be paid before a participant can successfully register for the subsequent semester of ASNL programs.
  • Safety Concerns


    • In the event that a participant runs from the designated program space it is understood that staff will contact the designated caregiver immediately. It is the caregiver’s responsibility to ensure that the contact information ASNL has on file is current and s/he is reachable.

    • Where possible and ensuring that it does not jeopardize the safety of other program participants, staff will follow the participant in an effort to ensure their safety. If staff determines the potential of an immediate threat of harm/injury they will call 911 and request the assistance of authorities.

    • Staff may request a caregiver remain onsite during programming if the participant has emerging safety concerns, such as running from programming areas. While onsite it is the responsibility of the caregiver to follow their participant should they leave the program space (either onsite or off-site).

    • Staff carry contact information for participants and their caregiver(s) with them for all off-site activities in case of an emergency.

    • Staff are certified in Non-Violent Crisis Intervention® (CPI) and may use this training if there is an immediate threat of harm/injury.

    • Staff are certified in Emergency First Aid/CPR C/AED and will perform First Aid (i.e.: apply a band aid, provide ice, etc.) if needed. In the event of an injury during programming parents/caregivers will be notified.
  • Designated Caregivers


    • For the protection of all program participants, please provide the names and phone numbers of individuals who would normally bring participants to and from programming.

    • If someone in addition to this list (unknown to staff) is picking up the participant the caregiver must notify staff ahead of time. Participants will not be released to an unfamiliar caregiver.

    • If a caregiver has sole custody of the participant, or if there are changes to a custody agreement, it is the responsibility of the caregiver to notify program staff of these changes.

    • Staff have the right to check identification of anyone picking up a participant from programming.
  • Internal Information Sharing

    Program staff recognize that ongoing information sharing can enhance program experience and overall support/service to families and individuals. Specifically, consent to information share will allow the coordination of quality, individualized programs for each participant. Information shared among program staff may include, but is not limited to:

    • medication changes

    • specific challenges at school or in the home

    • individualized strategies and routines to help with transitioning

    • individualized strategies and routines to help with anxiety reduction and engagement in programs

    • information shared at ISSP/IEP meetings
    I hereby grant permission to Autism Society, Newfoundland Labrador (ASNL) and its representatives to photograph and video my son/daughter, and otherwise capture their image. I further grant ASNL and its representatives the right to reproduce, use, exhibit, display, broadcast and distribute these images and recordings in any media now known or later developed for promoting, publicizing or explaining ASNL and its activities including their website. Such photographs are the property of ASNL and may be altered or combined with other images, text, and graphics without notifying me.
    Throughout each semester many programs take part in off-site field trips. How often groups take part in field trips and where the group visits depend entirely on the groups interest. Please note:

    •Information regarding the location, time and cost (if applicable) will be sent to each family via email one week prior to the field trip.

    •Parents/caregivers are welcome to take part in fieldtrips.

    •Staff carry contact information for participants and their parent/caregiver(s) with them for all off-site activities in case of an emergency.

    • Participants will always meet the program staff at the decided upon location; staff never transport participants in their personal vehicles.

  • Program Selection

    Please select the programs you are interested in participating in. Registration occurs on a ‘first come, first serve’ basis. Please see our website for specific program details.

  • * This application form will be forwarded to the community facility/ instructor. The community facility/instructor will then schedule and invoice for the program.

    In addition to weekly community based offerings ASNL hosts Family Events and supports community organizations when hosting weekly inclusive activities. For more information about Family Events and community activities please see our events calendar on ASNL's website https://www.autism.nf.net/events/

    If you have questions about any of the program offerings please contact Sarah White, Family and Community Service Officer, at swhite@autism.nf.net