Islands Trust Staff Meeting

Select Language:

...

* These fields are required

1 Welcome

2 Choose your accommodation

3 People in your group

Guest 1		First Name* Last Name* Email* Gender
Guest 1		First Name* Last Name* Email* Gender

Continue

5 Tell us more about you

Preferred name	Different than first name, what you are called or the name you go by. If you're joining us online, it's helpful if your registration matches your name on Zoom.
Pronouns	We invite you to share your pronouns with us during registration and again during the program. You can add your pronouns to you Zoom name.
Phone - Main
Phone - cell	Cell or mobile phone. Please note that your email and phone number may be shared with the program leaders. View terms and conditions for more details.
Phone - work	Work or office phone, if we need to reach you about your registration.
Address *	This is where we will mail any tax receipts.
Address 2
City *
State/Prov. *
Zip/Postal *
Country *
Gender
Birth Date *	A participant must be 19 or older to register for an adult program at The Haven
Diet Notes	Regular (includes meat option when available) Vegan Vegetarian Pescatarian Gluten Free Dairy Free Medically severe allergy The meal package includes either a regular or vegetarian/pescatarian option. Other special requests (gluten free, vegan, dairy free) will be accommodated at an extra charge of $5/day.
Emergency contact	Who should we contact in the event of a personal emergency? Please choose someone who will be available during the program.
Emergency contact phone	Phone for your emergency contact.
Emergency contact relationship	This person is my ____.
Why are you interested in this program? What do you hope to learn?	We will share your answers with the facilitator(s) in advance.
Do you have any accessibility needs you’d like us to be aware of?	No. Yes. Please send an email to register@haven.ca with more information. We look forward to hearing from you.
Is there anything else you'd like to tell us?	Please provide any other information that you would like us to consider when processing your registration request. If you would prefer to speak directly with a Registrar please email register@haven.ca
Online access *	I have internet access and the minimum device configuration.This online program will be hosted using one or more virtual platforms. By checking this box, you confirm you have the minimum device requirements noted in the program description and reliable internet connection.
Email communications	Yes, I agree to receive additional resources, special offers, and occasional updates related to opportunities at The Haven.As part of your program registration, you will receive a few essential emails from us related to your experience. Beyond that, we hope you'll opt in to stay connected. You can unsubscribe at any time.
How did you hear about this program? *	The program leader's website, email, or social media Email from The Haven The Haven's Social Media A friend or family member The Haven's Website During another Haven program Doctor, counsellor or medical professional alive magazine article Please check all that apply and provide the name of the person referring you if this applies.
Who were you referred by?	We want to thank them! Please include first and last name and email address.
聯絡電話 – 手機 Phone - cell	請留意您的手機、電話，或電子郵件，也許我們會與課程導師分享。 Cell or mobile phone. Please note that your email and phone number may be shared with the program leaders.
緊急聯絡人姓名 Emergency contact	如有個人緊急事件我們可以聯繫的緊急聯絡人大名 Who should we contact in the event of a personal emergency
緊急聯絡人電話 Emergency contact phone	緊急聯絡人電話 Phone for your emergency contact.
条款和约定 Terms and Conditions *	我接受所有条款和约定 I accept the terms and conditions.查看条款和约定。课程会被录影录音，未经你的同意，我们不会在课程以外使用。View terms and conditions This session may be recorded. The Haven will not share audio and visual of participants outside of the program without prior consent.

Continue

1 Welcome

2 Choose your accommodation

3 People in your group

4 Additional Programs

Participants

5 Tell us more about you

6 Donate to The Haven