Technology for Social Change Workshop Registration

Technology for Social Change Workshop

Big Brothers Big Sisters of Peel York is excited to be partnering with Up4 The Challenge to host a FREE, half-day TechRoots workshop on Saturday, May 9th from 10am – 1pm for female-identifying and non-binary youth. This will be held at BBBSPY’s Brampton office at 71 West Drive #23, Brampton ON.

TechRoots: Where Community, Creativity, and Technology Flourish!

TechRoots is an interactive workshop where youth build practical tech-design skills to address real social issues. Through ethical AI exploration, hands-on prototyping, and peer collaboration, participants learn to use technology creatively and critically as a tool for equity and community impact. For more information about Up4 The Challenge’s programming, visit their website at up4thechallenge.ca.

Interested in learning how you can solve real issues in your local community? Register below!

Snack and drinks will be provided, and youth will have the opportunity to meet other people their age, make new friends, and build community! Volunteer hours are also available for participation in this workshop.

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PARTICIPANT INFORMATION

Youth's Name*

First Last Preferred Name (if applicable)

Pronouns (Optional)

Youth's Date of Birth*

Parent/Guardian's Full Name*

Parent/Guardian's Email Address*

Does your child have any accessibility, learning or behavioural needs that we should be aware of?*

We realize that this information can be sensitive in nature. It will be treated with confidence and respect.

Yes

If yes, please provide details:

Does your child have any allergies or dietary restrictions?*

Snacks will be provided during all sessions, and a pizza dinner will be included on Thursday evening.

Yes

If yes, please provide details:

Media Consent

I hereby consent to Big Brothers Big Sisters of Peel York (BBBSPY), the use of any photographs, audio and/or video recordings of my child taken during the program as authorized by the BBBSPY President & CEO or Board of Directors. I give my permission for this media to be used by BBBSPY for purposes of promotional material including brochures, posters, newsletters, media information, advertisements, audio-visual productions and digital media, (such as the BBBSPY website and social media). Photographs or video productions may also be shared with community and school partners for program promotion.*

Yes, I give Media Consent

No, I do not give Media Consent

Informed Consent

I hereby give permission to Big Brothers Big Sisters of Peel York to make available their service to my child. It is my understanding that the intention of the Agency is to offer my child an opportunity to participate in a group program lead by a responsible adult, (minimum 18 years old, however, where appropriate supervision takes place, the volunteer may be younger), I understand that all efforts will be made to select a responsible Mentor who will facilitate the group program. In consideration for this service and other valuable consideration provided to my child by Big Brothers Big Sisters of Peel York, I release the agency of all responsibilities and liabilities in connection to their services provided in good faith, to myself or my child. I permit the agency to release any relevant information, including my personal information, to Big Brothers Big Sisters of Canada and their insurers, as may be appropriate in connection with any legal proceeding, inquiry or risk thereof. I understand that the collection of personal information about me or my child will be held in strict confidence and is to be used solely for the purposes of administering the program. I further agree that information about my child may be shared, at the discretion of Big Brothers Big Sisters of Peel York, with the group facilitator so that my child’s needs may be best met. I understand that this application is the property of Big Brothers Big Sisters of Peel York.*

Yes. I have read and understand this agreement. I acknowledge that I am the parent/guardian of the child for whom I am applying and that I hereby request Big Brothers Big Sisters service for my child. I give my child permission to participate in one or more group programs offered by BBBSPY. I am aware of and understand the risks, dangers and hazards associated with the above service and agree such service is suitable for my child.

Parent/Guardian Signature*

UP4 THE CHALLENGE MEDIA WAIVER

Once you hit Submit, you will be redirected to Up4 The Challenge’s Media Release Waiver. Please complete this waiver and then check your email, as you will be asked to verify waiver completion via email before it is officially signed. Once our team receives these pieces, we will follow up with you to confirm your child’s spot. Thank you!