Be Brave Ranch Registration Form

Please note that this assessment is private and confidential. The information is being collected for the sole purpose of ensuring that the Be Brave Ranch is the right program for the child being referred, and that they are likely to meet our eligibility criteria. If questions regarding this arise, we can contact the primary Parent or Guardian.

We ask that the primary provider of care for the child complete this form, or if it is a professional or other relative, that the relationship with the child being referred is clarified. If there is a second parent, guardian, or adult closely involved in the care of this child, please add this information as well. Also, if the parents are divorced, but permission from both parents is required, please also clarify this in answer to the question regarding “Relationship to Child”.

After completing the questionnaire, our clinical team will review the answers and contact you as soon as possible. This interaction will clarify eligibility for the BBR program, and if this is appropriate, we will provide details of the next steps.

Please note that at present only children within Canada are eligible for the Be Brave Ranch program. We are working at extending our program to be able to accept children from outside of Canada, but at this time it is not possible for this to occur.

If you have any questions, please don’t hesitate to contact us, and we thank you for your interest in the Be Brave Ranch Program.
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20% of survey complete.