EmailMe Form - KAZAM! Takataapui, Queer and Trans Youth Hui

KAZAM! Takataapui, Queer and Trans Youth Hui
Kazam! is a chance to focus on who we are, how we connect and how we become stronger through understanding our differences. It's a chance to start weaving an awesome national network for Takatapui, Queer and Trans youth.

Whether you live in the big smoke or out in the wilds we'd love to have you involved and are committed to helping you get here. So just get in touch.

Personal Info:

Name *

This will be kept strictly confidential and for admin purposes only

Prefix

This will be kept strictly confidential and for admin purposes only

First *

This will be kept strictly confidential and for admin purposes only

Last *

This will be kept strictly confidential and for admin purposes only

Suffix

This will be kept strictly confidential and for admin purposes only

Preferred Name

If different from above, what name would you prefer to be called?

What part of the country do you live in? *

Either put your region or nearest town/centre

Date of Birth *

YYYY

Are you above 16 years of age? *

If you are under 16 years of age, do your parents know you are coming? (We can discuss this with you)

Special Requirements:

Preferred Language; NZ sign, Te Reo, English etc.

Most of our Hui will be run in Spoken English, will you require a translator?

Do you have any specific access requirements?

Do you have specific dietary requirements? Vegetarian, hallal, gluten intolerant etc. *

Please Specify

Health support required? Asthma, epilepsy etc. *

Please Specify

Allergies? *

Please Specify

Contact Details:

Mobile phone

Landline

Email Address

Preferred way to contact you *

Who is a safe person we can contact in an emergency? *

What is their contact number? *

Who are they to you? Parent, friend etc. *

Are you connected with a youth group or Diversity Group? If so, which one(s)?

At the Hui:

My hopes for the Hui?

Would you like to contribute something to the Hui? Eg. Creating a workshop (on anything you are into), Mc'ing a session, a performance etc

Do you have experience facilitating groups? *

Would you be open to facilitating a session? *

Are you and/or your group able to fundraise to cover your transport to and from the Hui?

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