Registration – Holding a Vision for the Future Holding a vision for the future: Gatherings of United Church leadership from every congregation Please note that anything with an * beside it is required information and needs to be filled in before submitting your registration.ATTENDEE INFORMATIONLegal Name(Required) First Last Do you want your name to appear differently on your name tag? If so, please write your preferred name below.Please share what pronouns you use (if you feel comfortable doing so)Email(Required) Enter Email Confirm Email Phone(Required)Privacy Information and ConsentEastern Ontario Outaouais Regional Council (EOORC) protects your personal information by adhering to all legislative requirements with respect to privacy. The collection of information on this registration form is for the purposes of the organization of this event. Please be aware that photography and videotaping may occur at this event. These images may be published in print or posted online on our website photo galleries, on social media, or used at the discretion of EOORC. By submitting this registration form you are indicating your consent to the collection and use of your information and photo and/or video for the use of EOORC.Agreement(Required) I am aware that photos and videos will be taken at this event. I accept that my information will be collected and stored by EOORC for the purposes of the planning and organization of this event. (Questions? Please contact nmatkovsky@united-church.ca.)ATTENDANCEIn case of Emergency, please provide a contact name and phone number and your relationship to this contact.(Required)Your role at your Community of Faith and/or Pastoral Charge(Required)Your Community of Faith/Pastoral Charge (type NONE if not applicable)(Required)Municipality of Community of Faith/Pastoral Charge (type NONE if not applicable)(Required)Would you like to attend the September 19th session at Riverside United Church (Ottawa) or the Saturday October 4th session at Trinity United Church (Smiths Falls)? September 19th at Riverside United Church, Ottawa October 4th at Trinity United Church, Smiths Falls Both (Note: This option is for those who are planning the event. If you are not involved in planning the event, we encourage you to choose just one event as they have the same program.) LANGUAGESThese events will be in English. Le programme de ces évènements va se dérouler en anglais. Si vous voulez participer en français, veuillez nous contacter (nmatkovsky@united-church.ca) et on pourrait s’arranger pour, par exemple, un groupe de discussion en français.ACCESSIBILITYPlease note that both events are scent-free.Riverside Accessibility Information: The building is fully accessible. There is a 5 cm (2 inch) ramped rise from the drop-off zone to the front entrance. There is a fully accessible washroom. All rooms are on the same level. The accessible washroom is gender-neutral. As the nursery school will be using the women’s washroom, what is normally the men’s washroom will be gender-neutral during this event. Accessibility Information for Trinity Smith’s Falls: Trinity has an elevator to the Sanctuary and to the Fellowship Hall. There are accessible and gender-neutral washrooms.Do you have any accessibility requirements you would like to share with us? Are there any other ways we can create a meeting which will be accessible to you?LUNCHAt each event, lunch is provided free of charge. For the September 19th event at Riverside United Church in Ottawa, the lunch will be catered by Yasmin Syrian Cooking Ottawa and the menu is: Hummus Dip with Pita bread, Fattoush salad, cheese rolls, Colored rice with chicken and sauce, Moussaka, Basbousah(dessert)For the October 4th event at Trinity United Church in Smiths Falls, the lunch will be catered by the church. The menu is: a variety of sandwiches, veggies, fruit, pickles, cheese, olives and a dessert.Please choose one of the options below.(Required) Yes, I would like to have the lunch which is provided. No, I will bring my own lunch. Other THANK YOU FOR REGISTERINGThank you! When you click SUBMIT, you will immediately receive a notice on the screen that your registration is confirmed. You should receive an email confirming your registration, however, this feature isn’t always reliable. You are welcome to check with Natalie to make sure you’re registered: nmatkovsky@united-church.ca
