Language
English (Canada)
French (Canada)
Family Health Forum Registration
Attendees Name
*
First Name
Last Name
Attendees Email
*
example@example.com
Which virtual family health forum session would you like to attend?
*
Tuesday, May 28 starting at 6:00pm (EST)? (Corresponding time-zones are: 7:00pm AST, 5:00pm CT, 4:00pm MT, 3:00pm PT)
Thursday, May 30 starting at 9:00pm (EST)? (Corresponding time-zones are: 10:00pm AST, 8:00pm CT, 7:00pm MT, 6:00pm PT).
What Provincial or Territorial Chapter are you a part of?
*
Please Select
Prince Edward Island
New Brunswick
Nova Scotia
Newfoundland & Labrador
Quebec
Ontario
Saskatchewan
Manitoba
Alberta
British Columbia
Northwest Territories
Yukon
Role of the individual attending the Family Health Forum
*
Please Select
SO Athlete
Parent/ caregiver of SO athlete
Sibling of SO athlete
Extended family member of SO athlete
Support worker of SO athlete
SO Coach
SO Volunteer
Other
For Special Olympics Athletes only, please select your age range.
0-12
13-21
22-35
36-50
51-65
65+
If you are not a SO athlete, please select if a SO athlete will be attending the health forum with you.
*
Please Select
Yes
No
If you are not a SO athlete, please provide the full name of the athlete(s) you are associated with.
*
If you are attending the health forum from one device, how many participants will be attending?
1
2
3
4
5+
If you are attending the health forum on one device, how many Special Olympics athletes will also be attending?
0
1
2
3
4
5+
Do you consent to Special Olympics Canada sharing any post-event updates with you via email?
*
Yes
No
Would you like Special Olympics Canada to share your registration details with your local Chapter? (Note: If you choose no, your personal information won't be shared.)
*
Yes
No
Submit
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