Youth Leadership & Speaker Program Registration Youth Program Registration Updates Action4Canada's Oct 2024 Youth Leadership & Speaker Program Registration is Open!If you’re ever going to lose—and you are, because everyone does—then why not put a positive spin on it? How do you do that? By learning from it. A loss isn’t totally a loss if you learn something from it.. Dates: Oct 4 – Nov 1 2024, on FridaysTime: 4:00 - 5:30 pm PT / 7:00 - 8:30 pm ETDeadline for registration: Oct 2Cost: By Donation... Register below: Parents/Guardians/Youth please complete the following form for each person (aged 12 - 18 years) who will be participating. You will receive a registration confirmation and a link to register for zoom, which is required to attend the sessions. Information submitted will be kept private and will not be shared or sold. Youth / Participant InfoFirst NameLast NameYouth Email (optional)Gender Male FemaleBirth Year-Select-2006200720082009201020112012Month-Select-010203040506070809101112Day-Select-01020304050607080910111213141516171819202122232425262728293031Schooling-Select-Public SchoolPrivate SchoolHome SchoolGrade Level-Select-Grade 6Grade 7Grade 8Grade 9Grade 10Grade 11Grade 12Are you on Discord?Your main interests or hobbies?Parent / Guardian InfoFirst NameLast NameParent/Guardian/Main EmailMailing AddressCityCountry-Select-CanadaProvince-Select-AlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNorthwest TerritoriesNova ScotiaNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukonPostal Code Consent, Acknowledgement, Permissions, Release & WaiverEmail & Communications Consent: Yes I agree to receive emails and other communications from Action4Canada at the above contacts.Cameras & Video Must be On During Sessions: Yes. I acknowledge and agree to keep participant camera operational and on at all times for identification, security and safety purposes, during these sessions.Permission for the youth (above) to participate Yes I (parent/guardian) give permission for my child to participate in the Action4Canada Youth ProgramCONTENT / MEDIA RELEASE & WAIVER I grant consent with full permission and rights to Action4Canada Inc to use, without compensation, and/or my child's name, photos, stories, videos or any other media, on Action4Canada's Website, social media, reports, and or publications. Consent and Release Yes NoSUBMIT REGISTRATION
