Generations for Climate Justice: Registration Form

Generations for Climate Justice: Registration Form
Generations for Climate Justice (GCJ) is a free program that connects all 2SLGBTQ+ youth (ages 10 to 18) and older adults (ages 50+) to build impactful intergenerational relationships and foster collaboration on climate justice projects.

This program is designed to evolve gradually over the course of a year, with an emphasis on education, advocacy, storytelling and community building.

The program consists of several key areas of focus, including:
• Eco education projects
• Climate advocacy projects
• Climate change storytelling
• Nature education
• Emerging situations conversation circles
• Special projects and activities that span both generations

Questions? Email Erin at EOBrien@The519.org.
Name*

First NameLast Name
Pronouns*

He/HimShe/HerThey/ThemHe/TheyShe/TheyNot listed
Email*
example@example.com
Year of Birth*
Emergency Contact Information
Emergency Contact Name*

First NameLast Name
Relationship to you:*
Emergency Contact Phone Number*
Please enter a valid phone number.
Do you have any dietary restrictions or allergies?*

VeganVegetarianNo, I eat meat (beef, pork, poultry), and do not have any allergiesI eat meat, but not porkI eat meat, but not beefOther
Can you meet monthly and/or bi-monthly on Tuesday evenings?*

Yes, I can meet monthly AND bi-monthlyYes, but I can ONLY meet monthlyYes, but I can ONLY meet bi-monthlyNo, I cannot meet on Tuesday evenings
For the following question, please consider available times throughout the year and not only the summer.
We understand that everyone has varied schedules. Which times are you available to meet? Our starting date will take place Tuesday, July 8.*

4 to 5 p.m.4:30 to 5:30 p.m.5 to 6 p.m.5:30 to 6:30 p.m.6 to 7 p.m.6:30 to 7:30 p.m.7 to 8 p.m.
Please tell us a bit about yourself.
Please explain your interest in climate justice. Feel free to write about your interests, skills and experience more broadly as well.
Is there anyone (Gender Diverse Youth or LGBTQ+ Adult over 50) you would recommend to be a part of this program? Please type their full name and email address below.
(Recommend to) Name:

First NameLast Name
(Recommend to) Email:
example@example.com
What specific topics, if any, would you like to see covered in our Climate Justice program?
The personal information on this form is collected under the authority of the City of Toronto Act, S.O. 2006, Chapter 11, Schedule A, s. 136 (b) & (c). Personal information is used for the delivery of The 519’s programs and services for the purpose of registration. The 519 will not trade personal information with other organizations. Questions about this collection can be directed to the Privacy Officer at The 519, 519 Church Street, Toronto, ON, M4Y 2C9 by e-mail at Privacy@The519.org or by phone at 416-392-6874.
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Generations for Climate Justice: Registration Form

Emergency Contact Information