Register for Confronting the White Elephant

Your Name:*

Your Email:*

Your Phone Number:*

Your Location:*
---SummerlandPentictonOliverOsoyoosNaramataKaledenOK FallsKeremeosCawstonPrincetonOther (please specify below)

Other Location:

Which best of the following best describes you?*
---Indigenous/First NationInuitMetisVisible Minority (e.g. Black, Hispanic, Asian, etc)Invisible minority (e.g. white immigrant not from English/French speaking country)WhiteOtherPrefer not to say

Age Group:*
---15-2425-5455-6465 and overPrefer not to say

Gender:*
---Cisgender FemaleCisgender MaleTransgender FemaleTransgender MaleAgenderGender FluidNon-conforming/Non-binaryInter-sexThird GenderTwo SpiritOtherPrefer not to say

Do you require any accommodations to attend the event? We will do our best to provide the necessary supports:*
---NoneYes, blind or partially sightedYes, deaf or hard of hearingOther (please specify below)

Other Accommodation:

How did you hear about the Anti-Racism Forum?*
---SOICS, OneWorld FestivalTraditional Advertising (e.g. Newspaper, Radio, TV)Social MediaBlog or PublicationPosterCommunity Organization/Business (please specify below)Email BlastSearch Engine (e.g. Google, Yahoo, etc.)Word of mouth, Recommended by a friend or colleagueOther (please specify below)

Other Referral:

Please indicate your interest in the following workshops - Block 1 (choose 1)*
---The Truth About Racism Against Indigenous Peoples of CanadaStory Telling CircleUnderstanding and Identifying Online Hate SpeechWorkplace DEI

Please indicate your interest in the following workshops - Block 2 (choose 1)*
---The Truth About Racism Against Indigenous Peoples of CanadaStory Telling CircleYouth Engagement in Anti-RacismWorkplace DEI

What are you hoping to learn at the event?*

Would you like to be informed about future anti-racism initiatives?*
---YesNo

Do you have any food restrictions?*
---NoYes (please specify below)

Food Restriction:

By checking the box above, I understand that Penticton & District Multicultural Society (dba: South Okanagan Immigrant and Community Services; Hereinafter referred to as SOICS) may take photos and video at the event. By registering and attending the Anti-Racism Forum, I hereby give my consent to SOICS, its affiliates (e.g. funders and partners) and agents, to use my image and likeness and/or any interview statements from me in its publications, advertising and/or other media activities (including the Internet). This consent is given in perpetuity, and does not require prior approval by me.

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