CiviCRM - Canadian Association for Girls In Science (CAGIS)

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Participant Details

Participant Role

Youth Attendee

First Name *

Last Name *

Email *

Birth Date *

Notes/Comments/Allergies

Family Information

Parent/Guardian 1

Parent/Guardian 1 First Name *

Parent/Guardian 1 Last Name *

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Parent/Guardian 2

Parent/Guardian 2 First Name

Parent/Guardian 2 Last Name

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Aside from yourselves, please list other people allowed to pick up your child/children

CAGIS Ottawa – Nature Tech (12-16 years old)