Mushkegowuk Youth Workers Conference

Mushkegowuk Youth Workers Conference

June 9-11, 2025 Vaughan, ON
A conference for Mushkegowuk Youth Workers to network and gather to discuss ways to support our Youth with a holistic approach. Our theme of the event will be ..

"Working Together to Support our Youth"

Please note, only two youth workers per community will be selected to attend and have their travel fully covered. The Youth Department will work together in the selection process. If you are interested in attending and your employer will cover your travel, please communicate this in the form. Thank you.
Name (Preferred)*

First NameLast Name
Legal Name on ID for Travel Purposes*

First NameLast Name
Birthdate (DD/MM/YYYY)*
Email*
example@example.com
Phone Number*
Please enter a valid phone number.
Address*

Street Address (Please Include P.O Box)

Street Address Line 2

CityProvince

Postal Code
What is your Mushkegowuk First Nation:*
Any allergies (food included), chronic illness, or medical conditions? If yes, please describe.
Emergency Contact*

First NameLast Name
Emergency Contact Phone Number *
Emergency Contact Alternative Phone Number
Introduce Yourself!

Getting to know you as a Youth Worker:
Current Employment Title?*
What Mushkegowuk First Nation Community do you service?*
Please provide a brief description of your role:*
What type of events have you hosted within your role?*
What type of challenges and limitations have you faced that has affected the success of your programming?*
Suggestion Box (workshop topics, Presenters, etc) OR additional feedback.
Personal Details For Travel

Transportation, meals and accommodations provided:
*** IMPORTANT: For selected Youth Workers, air charter travel is provided for Attawapiskat, Kashechewan, Moose Factory and Fort Albany*** The charter dates are June 8 and 13th.

Air Canada Travel will also be provided to Toronto for those located in TTN/Cochrane, Chapleau, and Missinabie/Sault Ste. Marie.
Where will you be travelling from:*
What is your preferred method of travel?*
Please note that ground travel arrangements must be communicated upon selection.
YesNoUnsure
Consent Waiver
I hereby consent to participate in the upcoming Youth Workers Networking conference, Mushkegowuk Council's Youth Department's, for the dates of June 8-13th, 2025.

I understand that tobacco/niccotine (vape and cigarettes) are permitted but drugs and alcohol are not permitted. When at accomodations and outside of the responsibility of Mushkegowuk Council and the conference actvities; improper consumption/intoxication, or other innapropriate behaviour at accomodations will result in an immediate transportation back to their original pick up location.

I hereby acknowledge that certain RISKS OF INJURY are inherent to travel. I understand that the paramaters established for this trip are designed for the safety and protection of the participants and herby acknowledge to abide by the rules and regulations outlined during the trip.

In addition, I give my full consent and waive Mushkegowuk Council, and its hosting staff within Mushkegowuk Council Youth department, of fault for incident or injury that may be inflicted in the normal course of participation in the designated event.
Media Consent
I hereby give consent to Mushkegowuk Council Youth Department to photograph, videotape, or otherwise digitally record and use images and/or sound recordings of myself or my child (if applicable). This includes posts, publications and productions through any public media (i.e, radio, television, internet, social media, print) from Mushkegowuk Council or other partners' of the organizations. I understand that the intended use of such images and information is solely for the purpose of advertising, report writing, fundraising and/or the promotional and public awareness purposes for the organization. I hereby waive any privacy rights in the images or recordings within this release.*

Yes, I give consentNo, I do not give consent
Please sign here if you consent and confirm all the above information*
Name of Signature Printed*

First NameLast Name
CONTACT INFORMATION:

Mushkegowuk Council Youth Department

youthdepartment@mushkegowuk.ca

705-268-3594
Should be Empty:

Mushkegowuk Youth Workers Conference

Introduce Yourself!

Personal Details For Travel

Consent Waiver

Media Consent