QTPOC Kung-Fu

Preferred Name

First NameLast Name

What pronouns would you like us to use when referring to you?

Email

Address

Street Address

Street Address Line 2

Postal / Zip Code

Which dates are you signing up for? Note that ideally you should participate in three sessions as they progress every week.

How did you find out about this program?

Notice of Collection

The personal information on this form is collected under the authority of the City of Toronto Act, S.O. 2006, Schedule 11, Chapter A, s. 136 (b) & (c) and will be used for the delivery of The 519’s programs and services. The 519 will not use or disclose personal information beyond the scope defined in the program parameters in this form, in accordance with Municipal Freedom of Information and Protection of Privacy Act (MFIPPA). 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.

Please, click submit to confirm!