Murdered & Missing Indigenous Women & Girls Gathering

Full Name (required)

Street Address (required)

City & Postal Code (required)

Phone (required)

Email (required)

Specify Gender
FemaleMaleOther

Age
0-2021-2930-3940-4950-5960-6970+

Emergency Contact Name (required)

Emergency Contact Phone (required)

Relationship To Attendee (required)

Nation
BandInuitMetisOther Type

Band Name

Specify Other

What Days Are You Attending?
Both daysJune 5 onlyJune 6 only

Welcome Dinner Wednesday June 5, 2019
Yes

Describe Food Allergies Or Restrictions

Local Shuttle Service Pick-up
10th & Redford3rd & Argyle7-Eleven JohnstonM'akolaPAFC

Are You Requesting Travel Subsidy
Yes

Where Are You Travelling From?
MainlandVancouver Island

Are You Driving Your Own Vehicle?
Yes

Are You Travelling As A Passenger?
Yes

Are You Walking On A Ferry?
Yes

Where Will You Be Staying?
Home of friend or familyHotel or B&B

Questions, Concerns Or More Information Needed?