Take Our Kids to Work Day 2022 – Virtual Event Registration Form

London Health Sciences Centre is pleased to support Take Our Kids to Work Day! We are committed to Patient Care, Teaching, and Research and strive to be a place where students can learn, discover and acquire skills to achieve their goals for the future. We look forward to our shared journey with you during Take Our Kids to Work Day and hope that your experience with us is very rewarding. This years event will be virtual and will showcase numerous departments within LHSC!

Note: Do not enter a username or password into the login information to the right. This is for Student Affairs' use only.

Personal information on this form is collected under the authority of the Public Hospitals Act, Reg. 965, and will be used for the purposes of Take Your Kid to Work Day and to facilitate compliance with public hospitals' legislated accountabilities at London Health Sciences Centre.

Grade 9 Information

First Name

Last Name

School

School Board

LHSC Host / Parent Information

First Name

Last Name

Department

Site

One that you check regularly!

Presentation The link for the presentation will be sent to the email you have provided above a week before the event.

Confidentiality Requirements
All patients under care at London Health Sciences Centre (LHSC) and all LHSC staff/physicians have a fundamental right to have their personal information treated in confidence. While every effort is being made to honour this right in the development of the “Take Our Kids to Work Day” event, we also ask for your commitment to hold in confidence any information specific to patients or staff that may be included in the presentation. Please note that more information regarding this requirement will be provided at the start of the event.

Acknowledgment

I acknowledge and agree to the Privacy & Confidentiality responsibilities listed above.

E-Signature

The E-Signature will have the same binding effect as an original signature.