Thank you completing the pre-registration for the Third Annual Survivors of the Mohawk Institute (MI) Gathering.

June 25 - 27, 2024
Best Western Brantford, ON (please note this is a pet-free hotel)

There is no cost for MI Survivors to attend the gathering and all meals will be provided to you and (1) support person. Travel and accommodation support is also available to MI Survivors. A representative will contact MI Survivors by phone to assist them with accessing these supports.

Please note we may accept Survivors of other institutions; however priority will be given to Survivors of the Mohawk Institute Indian Residential School. All other prospective guests will be placed on a waitlist until May 15, 2024, at which time they will be contacted on a first come, first served basis.

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* 1. Full Legal Name

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* 2. Address, inclduing street number, street name, town/city, province and postal code (Please note this will determine if you are eligible for a travel reimbursement)

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* 3. Phone Number

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* 4. E-mail Address

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* 5. How Do You Identify?

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* 6. What day do you intend to arrive at the Gathering?

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* 7. What day do you intend to leave the Gathering? (Please note: travel reimbursements will be available beginning Thursday afternoon)

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* 8. Will you require a support person? (If No, please skip to Question 12)

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* 9. What is the name of the support person?
(Please note supports must be 18 years + to attend)

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* 10. What is their phone number?

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* 11. What is their e-mail address?

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* 12. Do you and your support person require a hotel room at the Best Western in Brantford, ON?
(Please note that no pets will be allowed at the hotel during the Gathering)

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* 13. Do you have any accessibility needs we should be aware of?

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* 14. How do you intend to get to the event?

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* 15. If you are traveling more than 500 to attend the Gathering, do you need a hotel room halfway?

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* 16. Do you have any dietary restrictions?

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* 17. What size t-shirt or sweatshirt do you wear? (Please note, Survivors of the Mohawk Institute will be given a sweatshirt at the event)

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* 18. During the Gathering, recorded podcasting sessions will be taking place, is this something you would be interested in participating in?

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* 19. In providing my information to Survivors' Secretariat, they agree to keep my information secure, private and confidential and it will not be shared without my express permission.

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* 20. By attending the Third Annual Survivors of the Mohawk Institute Gathering, all attendees consent to the potential release and publication of photos and audio/video recordings by Survivors' Secretariat. If you have concerns about this, please contact communications@survivorssecretariat.ca

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