Registration Form

Active Canterbury is passionate about supporting local activity providers and seeing community programmes and initiatives thrive.  Our workshops are designed to help providers grow their knowledge and confidence, try new ideas, network with other like-minded people, and keep up-to-date with latest trends and innovations.  Thanks to the generous support we receive from Pegasus Health and the Canterbury District Health Board these workshops are FREE to attend.

The information we collect as part of the registration process is used by us to help plan the workshops.  You have the right to access and correct any personal information held by us.  You can also choose to remove your details from our database at any time and we will not share your information with third parties. 

Please fill out your details below and click on the DONE button to submit your registration.  You will receive an email from us within 3 working days of registering to confirm your place on the workshop.

For more information about the workshop content please visit the Active Canterbury website or contact Kris Tynan on kris.tynan@xtra.co.nz or 021 262 8886.

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* 1. Name (first and last)

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* 2. Contact phone number (preferably mobile)

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* 3. Email

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* 4. Please tell us which groups you identify with

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* 5. Please indicate your age bracket and gender

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* 6. Job role (please tick all that apply)

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* 7. How long have you been an activity provider?

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* 8. Are you self employed, employed or a volunteer? (please elaborate in the box below if more than 1 option applies). Also, how many hours a week on average do you work?

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* 9. Please tick all the boxes below that apply

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* 10. How did you hear about the workshop?

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