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Black Liberation Cooking Club Form 2023
Black Liberation Cooking Camp will be happening online from July 10-14th for youth 12-17. Participants will receive all groceries necessary for cooking each day from 1-4pm.
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Priority of Admission
FOR YOUTH: Tell us about yourself - This information is voluntary and will be used to determined priority of admission into Freedom School. Admission to Freedom School is not on a first come-first serve basis, but is dependant on need.
1. For youth - Do you identify as Black?
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Your answer
2. What else do you want to tell us about your identity?
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Your answer
3. For youth - Where do you currently live? Do you have access to internet?
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Your answer
4. For youth - How would you describe your experience at school?
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Your answer
Youth Freedom Fighter Information
Tell us about your child. This information will help us to program for your child and to keep your child safe.
Name (last/first)
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Your answer
Gender Pronoun
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Your answer
Date of birth
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MM
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DD
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YYYY
Ontario Health Number
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Your answer
Residential Address (Number, street name, unit #, city, postal code. Please indicate if you lives at one address or alternates between 2+ addresses). We will use this address to drop off supplies and materials for you to do cooking.
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Your answer
Doctors name and phone number
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Your answer
Tshirt size
We will use this info to make you an apron
What is your T-shirt size:
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Your answer
Do you have any pertinent medical concerns? Ex: asthma, diabetes, sickle cell, epilepsy
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Your answer
Accessibility
Do you have access to a device to use for online learning? Ex: IPAD, Iphone, Laptop? Do you have physical accessibility needs? Ex: Do you require ASL interpreting or adapting of learning materials?
List accessibility needs
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Your answer
Learning Needs
Tell us about your learning needs!
What is your cultural foreground? (Ex: Nigerian, Jamaican, Scotian, Bajan, Black American)
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Your answer
Tell us a bit about how you learns best (Ex: auditory, visual, kinesthetic, hands-on)
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Your answer
How do you typically handle frustrating interpersonal situations? (Ex: shut down, talk it out)
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Your answer
Why are you interested in being part of FreedomSchool food sovereignty camp?
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Your answer
Any suggestions that will help us get to know you and help you adjust to Freedom School.
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Your answer
Parent(s)/Care giver's Information
Tell us about yourself and your child's parent(s)/guardian(s)
Parent(s) or Guardians (family name(s), given name(s)
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Your answer
Home Phone
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Your answer
Work Phone (if employed outside home)
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Your answer
Mobile Phone
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Your answer
Email address
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Your answer
Emergency Contacts (Freedom School - Toronto MUST have on file the names of three people who can help out if your youth should become ill/injured and we are unable to support remotely)
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Your answer
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