1 Start 2 Complete Instructions for Completing this Form Youth Retreats (also known as SCM’s or Steering Committee Meetings) bring youth in and from care between the ages of 14-24 from all across the province together to learn skills, have fun, build lasting friendships, and have their voices heard. Please download our handy information package to make sure you have everything you need before you start this registration form. You will not be able to save the form and come back to it. All information requested must be provided. If you have any questions or need help filling out your application, contact Marcey at: marcey.amaya@fbcyicn.ca. 604.355.2530 Please note that filling out this application form does not guarantee approval to attend. PRIVACY The personal information collected with this form is used by the Federation of BC Youth in Care Networks (the Fed) to ensure the safety and well-being of all participants at the Fed event. We may need to contact you regarding the information you provide and/or information relevant to the event. Please see our Privacy and Information Protection Policy for more information. Consent * By marking ‘Yes, I consent’ below, you give the Federation of BC Youth in Care Networks permission to collect and use your information as we described above. If you have any questions or need more information, please contact info@fbcyicn.ca. Yes I consent Adult Information First Name * Last Name * Legal First Name * Legal Last Name * Pronouns * She/Her She/They He/Him He/They He/She/They They/Them Self-Described If you marked your pronouns as 'self-described', please add your pronouns here Gender * Female Male Non-Binary Two-Spirited Other Sleeping Arrangements We have gender-neutral sleeping spaces available for folks who identify as gender non-binary or gender neutral, and trans folks who would prefer to sleep in a non-gendered space. Do you want to sleep in a gender neutral/non-gendered space? * Yes No Not Sure (a staff member will connect with you to help you decide where you'd be most comfortable) Adult Contact Information City/Community * Province * Phone Email * What's the best way to contact you? * Phone Email Emergency Contact Information First Name * Last Name * Relation to You * Phone * Phone 2 Email * Health and Wellness Information The information in this section is collected to ensure the safety, health, and well-being of all participants at the Fed event. It is important that all the questions are answered honestly and completely. We want to make sure you have the support and resources you need to have the best experience possible. BC Services Card Number (in case of emergency) * Dietary Restrictions & Allergies Do you have any dietary restrictions (personal preferences do not count)? * Check all that apply. Note: If there is nothing marked down on the registration form, you will not be provided a special dietary meal at the event. A list is kept by the Fed staff of who has dietary restrictions, and this list will be enforced None Vegan - no animal products Vegetarian - no meat Lacto-Ovo vegetarian - will eat dairy and eggs No red meat No pork No poultry No seafood No dairy No nuts Gluten sensitivity Celiac Other - please specify below If you marked 'other' above, please specify: Do you have any allergies? * Check all that apply. None Hay fever Animals Insects Medications Food Other Please specify about any allergies you listed above. Please let us know more specifically what you are allergic to (eg: dog hair, bee stings, peanuts, etc) Do you have any medical conditions that we should be aware of? Travel Arrangements How will you be getting to the event? * I will meet the Charter Bus at Sapperton Pensioners Hall: 318 Keary St, New Westminster, BC by 2:30pm I will make my own arrangements to arrive at Zajac Ranch: 15600 Florence Lake Rd, Mission, BC V4S 1C4 by 4pm I will require support with my travel arrangements Supporting Documents Zajac Ranch Acknowledgement of Risk File Please complete and attach the camp’s Acknowledgement of Risk Form.Files must be less than 10 MB.Allowed file types: pdf doc docx. Please click to download Zajac Ranch's Acknowledgement of Risk form. Code of Conduct File Files must be less than 10 MB.Allowed file types: pdf doc docx. Please click to download the Fed's Code of Conduct. Criminal Record Check with Vulnerable Sector Check Files must be less than 10 MB.Allowed file types: pdf doc docx. Acknowledgements and Consent Media Consent * Please review our Media Consent policy linked below. If you would like a Fed staff member to explain this to you, you can request this option below. I have reviewed, understand, and agree to provide media consent I have reviewed, understand, and do not agree to provide media consent I would like staff support to review the policies with me Read our Media Consent Policy here. Policies * Please review the key policies related to our programs and services linked below. If you would like a Fed staff member to explain them to you, you can request this option below. I have reviewed, understand, and agree to the linked Fed policies I would like staff support to review the policies with me Read our Fed policies here. Shared Expectations * Please review our Shared Expectations linked below. If you would like a Fed staff member to review them to you, you can request this option below. I have reviewed, understand, and agree to the linked Shared Expectations I would like a Fed staff's support to review the policies with me Please read our Shared Expectations here. Information Updates * Yes, I agree to update the Fed of changes to any information provided in this registration form between now and the time of the event. Failure to update your information with the Fed can lead to various consequences including being asked to leave the event. By submitting, I confirm that all information provided on the registration form is accurate and complete.
