Chaperone Registration Form Chaperone registration is now open for the 2026 Wabun Jr. Youth Gathering, taking place July 27–31, 2026 at Mattagami First Nation. "*" indicates required fields Step 1 of 5 20% Chaperone InformationInformation on the Chaperone attending the 2026 Wabun Jr. Youth Gathering.Name of Chaperone* First Last Phone*Email* First Nation Community*Which community will you be chaperoning for?Home Address Street Address City ProvinceAlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNorthwest TerritoriesNova ScotiaNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukon Province Postal Code Chaperone RoleWabun is committed to having chaperones who are positive role models in your community. Do you live Bimaadiziwin (A good life)?* Yes No Will you be chaperoning as a parent/guardian?* Yes No If yes, for which child/children? Emergency ContactIn the event of an emergency, the Chaperone needs a contact person. Name of Primary Emergency Contact* First Last Relationship*How does the Chaperone know the contact?Phone*Primary number for emergency contact Training and Required DocumentsDo you have up-to-date CPR/First Aid Training?* Yes No CPR / First Aid UploadUpload CPR/First Aid Training CertificateAccepted file types: jpg, gif, png, pdf, Max. file size: 6 MB. Have you taken the Food Handler Safety Training?* Yes No Food Handler UploadUpload Food Handler Safety Training CertificateAccepted file types: jpg, gif, png, pdf, Max. file size: 6 MB. Are you attending as staff?* Yes No Vulnerable Sectors Check* All chaperones that are not staff or a parent/guardian must provide a recent Vulnerable Sectors Check.Vulnerable Sector Check UploadUpload Vulnerable Sector CheckAccepted file types: jpg, gif, png, pdf, Max. file size: 6 MB. Allergies or Medical Conditions*Other Important Information or Supports Acknowledgement and Signature Supervise youth during all scheduled activities and free time. Actively participate in all activities and encourage all participants to become involved. Be alert to health needs and special problems of participants. Supervise clean up daily. Chaperones are positive role models who live a good healthy life. Chaperone Acknowledgement* I have reviewed and understand the general chaperone duties listed above.Signature*
