Naloxone Training Registration t’útenamtsut xwínilh s7i’xi Medication Instead of Shame
Thank you for your interest in our Naloxone Training. Please email wellness@squamish.net or call 604-982-7835 if you have any questions or have trouble accessing the form.
Full Legal Name
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First Name
Last Name
Email
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example@example.com
Phone Number
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Please enter a valid phone number.
I understand that the scheduled time for this training is 1:30pm-2:30pm
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Yes
No. I am interested in an after work training at 5:30-6:30pm, and understand that Community Health & Wellness will be in touch with potential dates for training at this time.
Please indicate which time you would like to sign up for
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1:30PM-2:30PM
5:30PM-6:30PM
Squamish Nation Status Number (if applicable)
If you are Squamish Nation Staff please indicate your department (if applicable)
I understand that photos will be taken during this workshop, and that I am consenting to my photo being taken by selecting the "I consent" option. I also understand that the photos may be used in a variety of promotional materials, including, but not limited to: annual reports, social networking sites, and other print and digital communications.
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I consent
I do not consent
Submit
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