Email Us About Your Child

Let us know as much as you can about your child’s needs and what your goals are for getting them involved.  We’ll call you within 2 business days of receiving this form to answer all your questions and arrange an orientation session.

Parent Name (required)

Your Email (required)

Phone Number (required)
Please include area code!

Child Name(s) (required) - separate by a comma for more than one

Age of Child

If more than one child, please indicate each age followed by a comma. (for example: 8, 11, 14)

Desired Program

Your Message

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309 Lorne Ave East, Stratford, ON, N5A 6S4 | Phone: (519)-271-7133 | Fax: (519)-273-3939 | big.info@beamentor.ca

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