2026 Language Immersion Program: Day Registration Form

Instructions

How to prepare?

Please read the instructions carefully before proceeding.

This form is intended only for participants in the Glendon Language Immersion Program for youth aged 13 to 15, attending one of the following sessions:

Ages 14–15: June 29 to July 17, 2026 (3 weeks)
Ages 13–14: July 20 to August 7, 2026 (3 weeks)

The questions on the form aim to collect information specifically about the participant. A section dedicated to parent/guardian information will be provided at the end of the form. We suggest that the participant and parent/guardian fill out the form together.

This form may take up to 30 minutes to complete. The form does not have an auto-save feature, so be sure to complete it in one session to avoid losing your progress. We highly recommend filling out the following form using a computer or a laptop.

What do I need?

Before You Begin

To help complete the registration smoothly, please have the following documents ready. Note that the below information should pertain to the participant and not the parent/guardian.

Required:

Photo ID
Social Insurance Number (SIN)
Health insurance/coverage information

If applicable:

Documentation for additional support needs (e.g., physician’s note, copy of individualized learning or educational plan)
Documentation for a medically required special diet (e.g., physician’s note)

Accepted file formats: PDF, JPEG, JPG, or PNG.

All information and documents will be kept confidential, used solely for verification purposes, and securely deleted after review.

Need help?

If you have any questions regarding registration, please contact us by email or phone:

Email: immersion@glendon.yorku.ca
Phone: +1 416-487-6708
Hours: Monday to Friday, between 9:00 a.m. and 4:00 p.m. (Toronto local time)

Our office is closed from 12:30 p.m. to 1:30 p.m. on weekdays for lunch, as well as on weekends and statutory holidays.

Registration Form

RM_Stats
Participant
Agreement
Health
Waiver
Payment
Participant Information

All questions refer to the participant’s information unless otherwise indicated.
Program Age Group^*
For ages 14-15: June 29 to July 17, 2026 (3 weeks)

For ages 13-14: July 20 August 7, 2026 (3 weeks)

Program Language^*
French as a Second Language (FSL)

English as a Second Language (ESL)

First Name^*
Last Name^*
Preferred Name
Phonetic Pronunciation of Preferred Name
Gender^*
Personal Pronouns^*
Complete Address^*

Address Line 1 ^*

Address Line 2

City ^*

Province or State ^*

Country ^*

Postal or Zip Code ^*

Email^*
Mobile Number^*
Other Number
Birth Date^*
Have you ever participated in the Glendon Language Immersion Program?
Previous Participation^*
Yes

No

If yes, in what year?^*

Personal Statement

In a few sentences, please explain your motivation for joining the Glendon Language Immersion Program. What are your personal and/or educational goals, and how do you hope this program will support your learning?
Statement^*

Additional Information

Do you identify as Indigenous (First Nations, Métis, or Inuit)? This helps us connect participants with Indigenous-specific resources and supports on campus.
Indigenous Identity
Yes

No

I prefer not to answer

Please upload a valid photo ID. This will help us confirm your identity upon arrival at the program.
Upload ID (accepted formats: PDF, JPEG, JPG, PNG).^*
If you are a Canadian citizen or permanent resident and would like to receive a T2202 (Tuition and Enrolment Certificate) for tax purposes, please provide the participant’s Social Insurance Number (SIN).
If you do not wish to receive a T2202, please indicate “N/A” below. Doing so confirms that you acknowledge and consent to the participant not receiving a T2202.
SIN^*

Program Agreement

This agreement applies to the Language Immersion Program offered at Glendon Campus, York University, for participants ages 13 to 15. The purpose of this agreement is to foster a safe, inclusive, and enriching environment that supports cultural exchange, educational growth, and language acquisition. These programs are designed to offer an immersive experience that not only enhances language skills but also encourages self-exploration, personal growth, and a deeper understanding of diverse cultures.
We ask that all participants commit to engaging with these core aspects of the program. If your intention is not to embrace the opportunities for cultural learning, self-reflection, and educational development, we kindly request that you reconsider your enrollment. This experience is as much about personal discovery as it is about language learning, and your active participation in this journey is vital to creating a positive and meaningful experience for all.
As a reminder, the Glendon Language Immersion Program is designed to provide a comprehensive linguistic and cultural learning experience. Through ongoing efforts, the program will offer a variety of excursions, activities, and programming tailored to educational and linguistic objectives.
By agreeing to the conditions outlined below, you help contribute to a supportive and transformative learning environment for everyone involved. Any violation or failure to adhere to these conditions may result in a participant being sent home and excluded from completing the program.
For a sample schedule of mandatory program activities, please refer below:

Programming for ages 14 to 15

Programming for ages 13 to 14

Program Conditions

Any one of the following will constitute sufficient cause for dismissal from the program:
1.^*
Any conduct characterized by disrespect, irresponsibility, disruption, lack of cooperation, or harassment towards any individual is strictly prohibited.
I accept.
1.1.^*
Acts of harassment, bullying (including cyberbullying), dissemination of gossip, use of inappropriate language, or engagement in slander, whether overtly or covertly, are deemed unacceptable. This encompasses inappropriate written communications via social media platforms, text messages, email, as well as postings in public areas of the campus such as classroom whiteboards or blackboards, public bulletin boards, washrooms, common spaces in campus facilities or residence halls, among others. Instances of sexual harassment will be addressed in accordance with York University’s Policy on Sexual Violence, accessible via this link: https://thecentre.yorku.ca/policy-and-process/
I accept.
1.2.^*
A strict zero-tolerance policy regarding all forms of violence, inclusive of verbal, physical, and sexual violence, shall be enforced. Participants found to engage in violent behaviour will be promptly expelled from the program.
I accept.
2.^*
Inflicting damage upon property or engaging in acts of vandalism against all York University premises, including those of the Glendon Campus, inclusive of public areas on campus, vegetation, residential facilities, and communal spaces, is strictly prohibited. This prohibition extends to the damaging or vandalizing of personal belongings or possessions of others throughout the program duration.
I accept.
2.1.^*
Any act of vandalism, including but not limited to the intentional destruction, defacement, or damage of property, will not be tolerated under any circumstances. This applies to all areas of York University campuses, including the Glendon Campus, and including outdoor spaces, residence areas, communal rooms, classrooms, and all common areas of the main campus buildings.
I accept.
2.2.^*
Vandalism of a more severe nature, or repeated violations, may result in immediate dismissal from the program. The participant will be sent home without the opportunity to complete the program, and no refund will be issued.
I accept.
3.^*
The possession and/or consumption of illegal drugs, non-prescription narcotics, and/or prescription medication for purposes other than those prescribed are strictly prohibited.
I accept.
3.1.^*
It is prohibited for individuals under the age of 19 to possess or consume alcohol, as well as to supply alcohol to any person below the age of 19.
I accept.
4.^*
Guests (defined as individuals not enrolled in the program) are not permitted to participate in or attend scheduled program activities whether on or off campus, including organized excursions and trips, as well as programming or scheduled events. This ensures that participants can fully engage in the program experience without disruption to the program or concern for safety.
I accept.
4.1.^*
For reasons related to security and room capacity limitations, guests, including but not limited to family members and friends, are not permitted to attend graduation ceremonies or other program events. We appreciate your understanding and cooperation in maintaining a secure and respectful environment for all members of the program.
I accept.
5.^*
While mental health resources are available to support participant during their stay on campus, our program is not equipped to function as a crisis centre. Any crisis situations that arise will be escalated to emergency services, including hospital or police intervention, as necessary. If a participant has experienced a recent crisis prior to the start of the program, we strongly encourage they prioritize their recovery and carefully reconsider enrolling in our program. A foreign environment may exacerbate symptoms and could hinder a participant’s well-being.
I accept.
6.^*
Upholding academic integrity stands as a cornerstone to the values upheld by both York University and Glendon Continuing Education. For detailed guidelines, please refer to York University’s Policy on Academic Integrity (https://www.yorku.ca/unit/vpacad/academic-integrity/).
I accept.
6.1.^*
Throughout assessments, projects, in-class activities, presentations, and homework assignments, participants are expected to demonstrate honesty and responsibility in their academic endeavours, adhering strictly to York University’s policies on academic integrity and academic honesty. Any involvement in academic misconduct may result in a grade of zero. This encompasses excessive reliance on or misuse of translation tools (Google Translation, DeepL, etc.), as well as the utilization of artificial intelligence tools (ChatGPT, etc.) for the generation of assignments or presentations, among other infractions.
I accept.
7.^*
Any damages, lost property, or unnecessary service or cleaning costs caused by a participant to the residences, classrooms, facilities and/or property of York University, including the Glendon Campus, through neglect, accident or intent will be charged to the participant(s) involved.
I accept.
8.^*
Glendon Continuing Education is committed to providing a positive, safe, and respectful environment for all York University staff, and participants. To maintain these standards, we adhere to a zero-tolerance policy for harassment, verbal or written, by parents and/or guardians toward any York University staff members, including but not limited to teachers, language monitors, administrative staff, cafeteria staff, housing staff and security staff, as well as other participants. Parents and/or guardians of the participants are to communicate with the program staff through appropriate channels, which may include email and scheduled phone calls during office hours.
I accept.
8.1.^*
Any form of harassment, verbal or written, whether over phone, email, social media, in-person communication or other means, is strictly prohibited. This includes but is not limited to threats of physical harm or damage to property, intimidating or coercive behaviour, unreasonable demands or expectations that disrupt the functioning of the program, disrespectful or derogatory language towards staff or participants, defamation of character, etc.
I accept.
8.2.^*
Staff and team members are not obligated to respond to harassing or abusive communications. If a parent and/or guardian engages in harassing behaviour, staff members have the right to cease communication immediately whether by phone, email or in person, filter the individual’s email or phone number, escalate the issue to appropriate authorities or program leadership if necessary, and implement additional safety procedures to protect staff and participants from ongoing harassment. For more information, please see the government of Ontario’s policy on Preventing Workplace Harassment here: https://www.ontario.ca/page/preventing-workplace-violence-and-workplace-harassment#section-2)
I accept.
9.^*
By participating in this program, I acknowledge that I am entering an area where photography, video recording, and audio recording may occur. I authorize York University’s Glendon Campus and its representatives to capture and use photographs, videos, and audio recordings of me. I further grant York University’s Glendon Campus the right to use, reproduce, display, broadcast, and distribute these recordings in any current or future media for promotional, public outreach, educational, and administrative purposes. All photographs, videos, and recordings will remain the property of York University’s Glendon Campus.
I accept.
10.^*
Cell phones or electronic devices must be put away when instructors, language monitors or staff are speaking or facilitating program activities to ensure a distraction-free environment. During unauthorized periods, excessive or inappropriate use of electronic devices – including but not limited to texting, phone calls, emailing, use of social media, or gaming – is strictly prohibited and may disrupt the program. Failure to comply with these guidelines may result in disciplinary action, including temporary confiscation of devices during unauthorized periods, or dismissal from the program.
I accept.
11.^*
Participants of the Glendon Language Immersion Program are not, under any circumstances, permitted to leave the Glendon campus unaccompanied during program hours. Participants must always be accompanied by a teacher, language monitor or program staff when leaving the campus grounds during program hours.
I accept.
11.1.^*
Participants must leave campus with a parent or guardian. All participants leaving campus with a parent and/or guardian must abide by the sign-out and sign-in procedures in place. No exceptions will be made. Failure to abide by the sign-in and sign-out procedures may result in disciplinary action, including dismissal from the program.
I accept.
11.2.^*
Under no circumstances can a participant be picked up by a parent, guardian or other adult during an off-campus excursion or any sort of off-campus trip. Participants can only be signed out by a parent or guardian at the Glendon campus during the office hours of the office.
I accept.
Note: If dismissed from the program, participants must leave the campus immediately, within 24 hours, and return home at their own expense.
By initializing below, I have read, understood, and agree to the Program Agreement Form.
Participant's Initials^*
Parent/Guardian Initials^*
Date^*

Health Accommodations

Participants are encouraged to identify any accommodations they may require throughout the program. Additionally, participants are requested to disclose any medical conditions, as well as prescribed medications they are currently taking.
This information will be kept confidential and will not negatively impact your application. This will allow us to ensure that participants are equipped resources needed to succeed during their time at Glendon and to provide optimal assistance in the event of an emergency.

Do you have health insurance?^*
Yes

No

If you have provincial health coverage, please indicate the province of coverage and provide your health card number. If you are covered by a private or non-provincial insurance plan, please include the name of the insurance provider, your policy number, and any other relevant details.
Health Insurance Information^*
Do you have any conditions that might require additional support or accommodation during the program (related to learning, physical or mental health, etc.)?
Additional Support^*
Yes

No

If yes, kindly provide details regarding your situation and specify any necessary accommodations by uploading an official document (e.g. physician’s note, individualized learning/educational plan, etc.).
Additional Support (Details)^*
Additional Support (accepted formats: PDF, JPEG, JPG, PNG).^*
Do you have any specific medical conditions? (e.g., seasonal allergies, asthma, diabetes, epilepsy, seizures, heart troubles, etc.)?
Medical Conditions^*
Yes

No

Medical Conditions (Details)^*
Are you taking any prescription medications?
Prescription Medications^*
Yes

No

Prescription Medications (Details)^*
Do you have any serious allergies that may require the use of an EpiPen?
Severe Allergies - EpiPen Required^*
Yes

No

If yes, please provide more details below.
Severe Allergies (Details)^*

Meal Accommodations

Please note that all our meals accommodate a wide range of dietary restrictions and preferences (for example: vegetarian, vegan, Halal, etc.). Please note that York University is not a nut-free facility.
Note: Regrettably, participants are not permitted access to a kitchen under any circumstance. If you require access to a kitchen, kindly consider seeking admission at another institution.

Please indicate your dietary preferences^*
I eat meat

I am pescatarian

I am vegetarian

I am vegan

Do you require a special diet for medical reasons?
Medical Dietary Needs^*
Yes

No

If yes, please provide more details in text bow below and upload documented proof from your physician.
Medical Dietary Needs (Details)^*
Proof of Medical Dietary Needs (accepted formats: PDF, JPEG, JPG, PNG).^*
Do you have any non-life-threatening food allergies or sensitivities?
Food Allergies/Sensitivities^*
Yes

No

Food Allergies/Sensitivities (Details)^*
Do you require a special diet for religious reasons?
Religious Dietary Needs^*
Yes

No

Religious Dietary Needs (Details)^*

Information of Parents/Guardians & Emergency Contact

Provide details for the participant’s parents/guardians and emergency contact.
Contact Person 1
First Name^*
Last Name^*
Relationship to Person^*
Email^*
Mobile Number^*
Other Number

Contact Person 2
First Name^*
Last Name^*
Relationship to Person^*
Email^*
Mobile Number^*
Other Number

In case parents/guardians are unreachable, please provide details for an emergency contact.
First Name^*
Last Name^*
Relationship to Person^*
Email^*
Mobile Number^*
Other Number

Family Doctor Information

First Name
Last Name
Clinic/Hospital Name
Clinic/Hospital Address

Address Line 1

Address Line 2

City

Province or State

Country

Postal or Zip Code

Phone Number
Other Number

Waiver

I understand that participation in the Language Immersion Program, hosted by Glendon Continuing Education, both on and off the Glendon Campus of York University, involves a certain degree of risk that could result in injury, death or loss or damage to person or property. After carefully considering the risk involved, I hereby release, hold harmless and waive all claims associated with the scheduled activities of the Language Immersion Program hosted by Glendon Continuing Education, which I may have against Glendon Continuing Education on Glendon Campus of York University, its employees, directors, agents, and volunteers.
I have read and understood the above.^*
Yes

Future Contact

I give York University’s Glendon Campus permission to contact me about future campus programs, events, and activities.
Contact Consent
Yes

No

Registration Fee and Security Deposit Payments

Participant Type^*
Domestic: Full-Day Instruction ($2,500)

Domestic: Half-Day Instruction - Mornings Only ($1,300)

International: Full-Day Instruction ($2,900)

International: Half-Day Instruction - Mornings Only ($1,700)

I agree to pay the total for the Language Immersion Program^*
Yes

Name on Credit Card^*

Please Read Below Before Submitting

To complete your registration, please click on the "Proceed to Payment" button below and kindly WAIT to be redirected to the product and billing page.
We thank you for your interest in the Glendon Language Immersion Program and we look forward to meeting you soon!

2026 Language Immersion Program: Day Registration Form

Instructions

How to prepare?

What do I need?

Need help?

Registration Form

Participant Information

Personal Statement

Additional Information

Program Agreement

Program Conditions

Health Accommodations

Meal Accommodations

Information of Parents/Guardians & Emergency Contact

Family Doctor Information

Waiver

Future Contact

Registration Fee and Security Deposit Payments

Please Read Below Before Submitting

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