Third Annual Bemishkaajig Canoe Trip Registration Form

Bemishkaajig 2024

Registration
Wasauksing Health and Social Department, and the Georgian Bay Anishinaabek Youth are partnering to offer our local young people the 2024 Bemishkaajig Youth Canoe Trip during August 8th - 11th. We will be paddling from Three Mile Beach to our takeout point at the Wasauksing Marina.

This four-day and three-night journey will provide an opportunity for young people to engage with teachings, learning opportunities, and community members that will help them navigate "The Fast Life" as young people.

All participants will be required to complete and submit a registration form and waivers.

If you have any questions, or concerns, about the trip please don't be afraid to reach out to Dawson Bloor at gba.youth@gbbr.ca or Meaghan Tabobondung at mtabobondung@georgianbaybiosphere.com

If you need any assistance with registration contact Dawson Bloor gba.youth@gbbr.ca
This information will be used for the sole purpose of health, safety, and risk management. All information will be kept confidential.

I understand.
Name of Participant*

First NameLast Name
What are your Pronouns?
Age*
Self-identifying Indigenous ancestry and roots:*

I am AnishinaabeI am MohawkI am MetisI am CreeI am InukOther
First Nation Affiliation

WasauksingShawanagaMagnetawanHenvy InletMoose Deer PointOther
Email address. (ALL correspondence relating to Bemishkaajig 2024 will be shared via email)*
example@example.com
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Emergency Contact Information
Name*

First NameLast Name
Phone Number*
Please enter a valid phone number.
Email*
example@example.com
Relationship to you?*
Medical Information
Health Card Number?*
Any Allergies?

YesNo
If yes, please specify.
Do you have an accessibility needs/accommodations or considerations?*
Do you have any pre-existing health conditions or are taking any medications we should be aware of?*
How would you rate you swimming skills?

1

2

3

4

5

1 is Worst, 5 is Best
How would you rate you canoe paddling skills?

1

2

3

4

5

1 is Worst, 5 is Best
Is there anything else we should know or be aware of?
Camping Gear
Please click all that apply. Do you have the following:*

TentSleeping BagHatWatershoesSleeping MatRain CoatWater BottleHiking BootsBug JacketHead LampSunscreenEpi - PenSunglassesOther
Any further Questions, comments or concerns?

Bemishkaajig 2024

Emergency Contact Information

Medical Information

Camping Gear