KPE Logo
Junior Blues Intake & Support Form

The Junior Blues program strives to make learning enjoyable for all participants. Children and youth are expected to be able to participate in the instructional experience with minimal adaptation; otherwise an inclusion aide may be required. Please note that if abilities are not disclosed at the time of registration, assistance will be limited. We strongly encourage parents/guardians to share information about their child that may affect their experience in the Junior Blues programs.
This form is intended to provide information to staff for any participant who requires support or modified programming due to exceptionalities. Information on this form will be kept in confidence and shared only with staff working with your child as needed.
Text questions are not mandatory, please answer those that you feel would help to make your child's experience a success.

More information, check here or email:

Please ensure you click "Finish" at the bottom of the page to complete the process and have it submitted to us automatically. You may save and exit at any time and resume where you left off at a later time by re-opening the survey.
What program is your child registered in?
What program is your child registered in?
What program is your child registered in?
What program is your child registered in?
If registered in Aquatics, what is your child's swim level or ability?
What is the preferred time of day for contact?
Please check any exceptionalities your child experiences
Mild Moderate Severe N/A
Please describe your child's exceptionalities.
What are the goals for your child in this program?
What are some of the things your child excels at or enjoys?
Are there activities/actions your child does not like? Is there anything that causes stress for your child?
Please describe any successful techniques used to assist your child to engage in program activities (e.g. visual aids, cue words, interests).
Are there any special concerns that the staff should be aware of (e.g. medical condition)?
Is there any additional information you would like to share with us?
Next Steps: A Junior Blues staff member will contact you prior to the program start date via phone or email to discuss how best to support your child in our program(s).
Privacy Notice
The University of Toronto collects, creates, uses, maintains, discloses and disposes of information for the purposes of operating the programs and business functions of the University in a manner consistent with the Freedom of Information and Protection of Privacy Act. If you have questions please refer to or contact the University Freedom of Information and Protection of Privacy office at 416.946.7303, McMurrich Building, room 201, 12 Queen’s Park Crescent West, Toronto, ON, M5S 1A8