Teen Night Payment Form

Teen Night

Please note that Red Roof Retreat cannot provide 1:1 support for any teen. Typically the ratio of staff to
clients at Teen Night is 1:3. Red Roof Retreat has the right to accept or deny a registration at their
discretion or to send a teen home early due to health, medical or behavioural concerns.

Cost is $45 per evening.

Please enter the number of days you would like to pay for and then select which dates your teen will be attending:


Note that Registration closes the Thursday before Teen Night. Please pay and register your teen before then to ensure their spot.


Number of Days

Number of Days with a Worker

Final Total:

Contact Information

Clients Name
Confirm Email*

Registration Details

To Register, you must complete all of the following:
1. Application Form
2. Agreement of Waivers
3. Photo of Teen***
4. Payment

Confirmation and receipts will be issued when above requirements are complete.


Payment must be made by 4pm on Thursday before the scheduled program date. 

We are unable to issue refunds without adequate notice. 

If your teen cannot attend certain days, please email recreation@redroofretreat.com or call 289-362-6104 by the Thursday before the scheduled date. You will be reimbursed in January for any program days your teen did not attend from October - December and in May for days not attended from January - May.


If your teen is new the program please contact our Recreational Program Coordinator at the information below to receive more information.


recreation@redroofretreat.com or (289)362-6104

Payment Information

Payment Type
We only accept credit/debit card payments. After you complete this form, select Submit to enter your card details into our secure transaction processor. Your submission will be processed when you finalize your secure payment information.
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