March Break Youth4Action Leadership Boot Camp

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Last name *

Email *

School district *

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School name *

Grade *

Age *

Phone *

Why are you inspired to learn more about sustainability, leadership, and protecting healthy waters. (Key focus for this boot camp) *

Emergency contact first and last name *

Emergency contact relationship to applicant *

Emergency contact phone number *

Do you have any dietary requirements *

Will you require any special assistance while at the boot camp (i.e. physical limitations that require accommodations, or other)? Please explain what assistance will be required. Because of the nature of Youth4Action being a program with limited on-site ability to accommodate, the program lead will follow up to discuss. *

Collection notice:
The personal information that you provide on this form is being collected under section 26(c) of the Freedom of Information and Protection of Privacy Act. This information will be used for the purpose of administering the Metro Vancouver Youth4Action Leadership Boot Camp: Source to Sea. For further information about this collection, please contact a Privacy Officer at Metro Vancouver, Metrotower III, 4515 Central Boulevard, Burnaby, BC, V5H 0C6 or 604-432-6200 or privacy@metrovancouver.org.

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