2023 Citizens Assembly Registration
Legal Name
*
First Name
Middle Name
Last Name
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Community Affiliation
*
Stswecem’c Xget’tem First Nation
Canim Lake Band
Williams Lake First Nation
Xatśūll First Nation
Organization
Select Day or Days
*
Wednesday, May 24, 2023
Thursday, May 25, 2023
Childern
*
Yes
No
Children(s) Full Name
Emergency Contact Name
*
First Name
Last Name
Emergency Contact Phone Number
*
Please enter a valid phone number.
Food Allergies
*
Yes
No
If yes, please specify
Medical Conditions
*
Yes
No
If yes, please specify
Transportation required
*
Yes
No
Special travel needs?
Accommodations required
*
Yes
No
Special accommodations needs?
*
Yes
No
If yes, please specify
Submit
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