2nd Annual Sharing Experiences Workshop - Credit Valley Conservation Survey

Thank you for registering for the 2nd Annual Sharing Experiences Workshop hosted by your local Conservation Area and Stewardship Council. Groups and individuals who undertake environmental projects in their community are invited to attend. Participants will share their experiences and gain valuable knowledge on stewardship initiatives.

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1. First Name:

First Name:

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2. Last Name:

Last Name:

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3. Address (Street, City, Postal Code):

Address (Street, City, Postal Code):

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4. Phone Number (including area code):

Phone Number (including area code):

5. Email Address:

Email Address:

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6. Affiliated Organization:

Affiliated Organization:

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7. Did you attend last years workshop?

Did you attend last years workshop? Yes

8. If you are interested in carpooling to the workshop, please select the appropriate carpool region. The email address you have provided will be circulated to others who select your same carpool region; attendees can then arrange convenient meeting places and departure times between themselves. Please be sure to submit an email address if you are planning to carpool.

If you are interested in carpooling to the workshop, please select the appropriate carpool region. The email address you have provided will be circulated to others who select your same carpool region; attendees can then arrange convenient meeting places and departure times between themselves. Please be sure to submit an email address if you are planning to carpool. Burlington, Oakville, Mississauga

Caledon

Flamborough

Guelph

Haldimand, Norfolk

Halton Hills, Milton

Kitchener, Cambridge, Waterloo

Niagara, East Hamilton

Other (please specify)

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9. Photos may be taken at this event to be used for promotional purposes by local Conservation Authorities and Stewardship Councils. Please read the statement below and indicate whether or not you will permit the use of any photos containing your image.

PHOTO PERMISSION
The undersigned authorizes the program partners below to take photographs and/or film/video footage and to obtain quotations and information. Such photographs, film/video footage and recorded comments may be used for publications and broadcasts which may include but not be limited to the following: newspapers, radio television, staff newsletters, photographic displays, and publicly distributed publications such as annual reports, external newsletters, news releases, pamphlets, brochures, flyers, promotional and fundraising publications.

Photos may be taken at this event to be used for promotional purposes by local Conservation Authorities and Stewardship Councils. Please read the statement below and indicate whether or not you will permit the use of any photos containing your image. PHOTO PERMISSION The undersigned authorizes the program partners below to take photographs and/or film/video footage and to obtain quotations and information. Such photographs, film/video footage and recorded comments may be used for publications and broadcasts which may include but not be limited to the following: newspapers, radio television, staff newsletters, photographic displays, and publicly distributed publications such as annual reports, external newsletters, news releases, pamphlets, brochures, flyers, promotional and fundraising publications. Yes, I grant permission to use my photograph

No, my photograph can not be used

10. As there is a seperate entrance that is wheelchair accessible, please advise us if you require a special accommodation regarding access.

As there is a seperate entrance that is wheelchair accessible, please advise us if you require a special accommodation regarding access. Yes, I require special accommodations.

11. Do you have any special dietary requirements?

Do you have any special dietary requirements? Vegetarian

Vegan

Gluten Free

Other (please specify)

If you are unable to attend, please notify us to cancel as there is a high demand for this workshop.Thank you.

2nd Annual Sharing Experiences Workshop - Credit Valley Conservation

*1. First Name:

*2. Last Name:

*3. Address (Street, City, Postal Code):

*4. Phone Number (including area code):