SYP Outings Form

SYP Outings

Thank you for your interest in Families Matter Programs. Please submit this form to request tickets for an upcoming SYP Outing. Final confirmation with be completed by a member of the SYP Team.

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SYP Outing

Name(Required)

First Last

Phone(Required)

Email(Required)

Adult's Gender(Required)

Date of Birth(Required)

Are you a current/previous client?(Required)

Yes

Funders' Questions

Address(Required)

Street Address City Province Postal Code

Were you born in Canada?(Required)

Yes

How many years have you lived in Canada?(Required)

Less than 3 years

3-5 years

6-10 years

+11 years

Where were you born?(Required)

Are you Indigenous?(Required)

Yes

Are you Francophone?(Required)

Yes

Highest level of Education Completed?(Required)

Prefer no to say

Some High School

High School

University

Vocational/Community College

In the past 6 months, have you had difficulty paying for essential expenses such as housing, groceries, transportation, or utilities?(Required)

Yes

Is English your primary language?(Required)

Yes

What is your primary language?(Required)

How did you hear about Families Matter?(Required)

Emergency Contact Name(Required)

First Last

Emergency Contact's Phone Number(Required)

Family Members

Add another adult?(Required)

Yes – Add Adult

Adult 2 Information

Adult 2's Name(Required)

First Last

Adult 2's Gender(Required)

Adult 2's Birthdate(Required)

Adult 2's Phone(Required)

Adult 2's Email(Required)

Add a child?(Required)

Yes – Add Child

Child Information

Child's Name(Required)

First Last

Child's Gender(Required)

Child's Birthdate(Required)

Add another child?(Required)

Yes – Add Child

Child 2 Information

Child 2's Name(Required)

First Last

Child 2's Gender(Required)

Child 2's Birthdate(Required)

Add another child?(Required)

Yes – Add Child

Child 3 Information

Child 3's Name(Required)

First Last

Child 3's Gender(Required)

Child 3's Birthdate(Required)

Additional Information

Please let us know if there are any information about your family we should be aware of:

Examples: dietary restrictions or food allergies

SYP Outings

Funders' Questions

Family Members

Adult 2 Information

Child Information

Child 2 Information

Child 3 Information

Additional Information

Families Matter

Horizon / Admin Centre

Midnapore Family Centre