Roots of Resilience Registration Form 2026-2027

Roots of Resilience Registration Form
Weyt-k (hello) cousin!

Roots of Resilience is a no-cost program about connecting with the land, culture, and community. This form will help us get to know you, and how we can support you best.
Let's get to know you, stemét (friend)!
Preferred name

First NameLast Name
Gender
You can skip this question if you'd rather not share
Pronouns (how would you like us to refer to you?)
You can skip this question if you'd rather not share
Birthday

MonthDayYear
Age
Ancestry
Ancestry
Where are you from, cousin? (e.g. your nation, where you live, anywhere you consider "home")
Accessibility needs (how can we support you at camp?)
Are there any transportation barriers that would make it difficult for you to get to camp?
Do you have any favourite hobbies?
Are there any cultural activities that matter to you, or that you want to learn more about?
Contact Information

How can we stay in touch with you?
Phone Number
Format: (000) 000-0000.
E-mail
Parent/Guardian Info

If our friend is under 18, please provide contact info for their adult at home.
Parent/Guardian's Name

First NameLast Name
Relationship
Parent/Guardian Phone Number
Format: (000) 000-0000.
Alt. Phone Number
Format: (000) 000-0000.
Parent/Guardian E-mail
Alternative Contact
Alternative Contact's Name

First NameLast Name
Relationship
Alt. Contact's Phone Number
Format: (000) 000-0000.
Alt. Phone Number
Format: (000) 000-0000.
Alt. Contact's E-mail
Camp dates

We've got four fun events planned for Roots of Resilience:

Nov. 21-22: Fall youth retreat

Feb. 20-21: Winter youth retreat

May. 8-9: Spring youth retreat

Jun. 5: Celebration, Ceremony & Graduation with youth, families & Elders
Can you make it for all four dates?
Almost there, stemét (friend)!
Before Roots of Resilience starts, we'd love to connect with you and talk about what the program will look like. How would you like us to reach out?
How did you hear about Roots of Resilience?
Is there anything else it would be good for us to know?
Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Signature (Parent/guardian sign if participant is under 18)
Should be Empty: