Lanark Site - Community Programs Registration Form

*Indicates a required field

 If you need any assistance with registering, please contact Pam at 613-259-2182, ext. 2306
Online format progams use ZOOM ( Please complete this registration form and more details will be emailed to you regarding participation in our online programs. Please note, you must have high speed internet service with an internet connection – broadband wired or wireless (3G or 4G/LTE). Minimum bandwidth is 600kbps (up/down) and recommended is 1.5 Mbps (up/down). You can check your Internet bandwidth by going to You also need a microphone and webcam (camera built in or attached).

If you do not have all three please do not register for online Programs.

You can call ConnectWell Community Health for more information – 613-259-2182.
e.g. 12/03/1955
Telephone Number (Please provide only numbers where you permit us to call)
Please provide only email that you permit us to use to contact you.
Emergency Contact