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London Area BrainWAVE | Fun at The Factory
Brain Tumour Foundation of Canada is excited to invite you to the London Area BrainWAVE pediatric support Fun at The Factory day - an afternoon of arcade games, mini-golf, lunch, and community!
EVENT:
London Area Brain Tumour Foundation BrainWAVE Factory Fun Day
Date:
Saturday, Nov 7, 2026
Time:
Lunch and reception at 1:00 p.m.; Arcade and mini-golf from 2:00 - 3:30 p.m.
Location:
· The Factory (https://thefactorylondon.ca/)
· Address: 100 Kellogg Ln
London, ON N5W 0B4
(https://maps.app.goo.gl/EUyFaM31FRDUWh288)
Lunch:
· Each child under 10 will get a "Kid's Combo Meal Voucher" with the choice of chicken fingers, grilled cheese, hamburger, or hot dog with fries and a small fountain drink.
· Each attendee over 11 will receive a "Canteen Combo A Meal Voucher" with the choice of chicken fingers, hot dog/pogo; jumbo slice of pizza, or cheeseburger, with a side (Medium Fries, Small Poutine, or a Bag of Chips) & Drink (Medium Fountain Pop or Bottled Water)
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BrainWAVE is a pediatric support program for families with a child (19 years of age or younger) with a brain tumour. The program offers children, teens, and caregivers the opportunity to connect with other families in a similar situation and to obtain much-needed support, information and education.
Parent/Guardian(s) information
*
First
Last
Person 1
Parent/Guardian date of birth
*
MM
/
DD
/
YYYY
Email
*
Phone
*
###
-
###
-
####
Street Address:
eg 123 Main Street
Address Line 2
eg. PO Box 56 or RR 4
City
eg. London
Province
Please select
Alberta - AB
British Columbia - BC
Manitoba - MB
New Brunswick - NB
Newfoundland and Labrador - NFL
Nova Scotia - NS
Ontario - ON
Prince Edward Island - PEI
Quebec - QC
Saskatchewan - SK
Northwest Territories - NT
Nunavut - NT
Yukon - YT
Postal Code
eg. A1A 1A1
To help us determine the number of adult tickets needed, is there an additional parent/guardian we should include in your family's profile?
*
Yes / Oui
No / Non
Additional parent/guardian details: Please provide the full name, date of birth, and email address.
Patient/Survivor name or Volunteer
*
First
Last
(if you are a volunteer, please list "Volunteer" as the last name)
Date of birth
*
MM
/
DD
/
YYYY
Do you require any accommodations for accessibility or mobility?
*
Yes / Oui
No / Non
If yes, kindly provide further accessibility or mobility details below:
Lunch and drinks will be provided. Do you have any specific dietary restrictions?
*
Yes / Oui
No / Non
If yes, kindly provide further dietary details below:
Please list the allergy/restriction and the name of the individual
To help us determine the number of other tickets needed, are there any additional siblings we should include in your family's profile? Please also list dietary or mobility restrictions:
*
Yes / Oui
No / Non
Additional sibling/family details. Sibling 1:
Please provide First Name Last Name and date of birth for Sibling 1
Additional sibling/family details. Sibling 2:
Please provide First Name Last Name and date of birth for Sibling 2
Additional sibling/family details. Sibling 3:
Please provide First Name Last Name and date of birth for Sibling 3
To participate in BrainWAVE events, all attendees must adhere to the
terms and conditions
outlined on our website. These guidelines ensure a safe, inclusive, and respectful environment for everyone involved. By registering, you acknowledge and accept these terms, helping us create a positive experience for all participants.
*
I acknowledge and agree to the terms and conditions.
Emergency Medical Treatment
*
I hereby consent to and permit emergency treatment in the event of illness or injury.
By completing this form, we will add your family profile to our BrainWAVE/GOcervo family list, enabling you to receive updates about upcoming events and resources. To learn more about our BrainWAVE/GOcervo program, please visit
our website
.
