Supporting grassroots ideas that strengthen connection, community impact, and engagement.

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1. Name (Required.)

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2. Phone Number (Required.)

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3. Email Address (Required.)

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4. City and Province

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5. How would you best describe yourself?

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6. We would love to hear more about your event/initiative. What is your idea?

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7. Please share the primary goal of your event/initiative (check all that apply):

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8. Who will directly benefit from your event/initiative? (Required.)

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9. Will this event/initiative be accessible? Please describe the steps you have taken to ensure all can participate safely. (Required.)

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10. Are there any safety risks or concerns that Muscular Dystrophy Canada should be aware of?

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11. Estimated number of people this event/initiative will serve:

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12. Total amount requested (maximum $500):

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13. Please share a breakdown of the expenses.

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14. When would you like to host your event/initiative?

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15. Are you willing to share photos, quotes, or a reflection after your event/initiative?

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16. A member of our team will reach out for more information. How can we best reach you?

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