MOOSE CREE FIRST NATION
RESIDENTIAL SCHOOL INTERGENERATIONAL SURVIVORS GATHERING
September 9 - 12, 2024 - Moose Factory, ON
DELEGATE INFORMATION:
Registration Form to be completed by Delegates only (not facilitators)
Salutation:
*
Mr.
Mrs.
Miss
Ms.
*
First Name
Last Name
Date of Birth and Age
*
Email:
Address:
Street Address
City
Province
Postal Code
Phone Number
Format: (000) 000-0000.
Name of First Nation
*
Residential School History:
Did you or your parent/guardian attend Residential School?
*
Yes
No
Residential School History - What schools did you or your parent/guardian attend?
Bishop Horden Hall
St. Anne's
St. John's School Chapleau
Shingwauk
Fort George
Other
Photo/Media Permission & Food Allergy/Food Restrictions:
If my registration is accepted, I hereby give permission for Moose Cree First Nation to use photo/media to promote the Residential School Intergenerational Survivors Gathering.
*
Yes
No
Do you have food allergies/food restrictions? If yes, please describe.
Emergency Contact and Support Person Information:
Emergency Contact Name:
Emergency Contact Relationship:
Emergency Contact Number:
Will you be travelling with a Support Person (escort to help you)? If yes, please state their name/relationship?
Transportation/Accomodation Information:
(Travel will only be provided for Moose Cree Members)
Do you require transportation?
*
Yes
No
Method of Transportation
Bus/Train
Vehicle (km's to be provided for Out of Town MCFN Members)
Boat Taxi
Accommodations:
Private
Local Hotel/B&B
Not required - I live in Moose Factory/Moosonee
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Submit
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