Empowerment Fund Application

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At ICD, we firmly believe that finances should never be a barrier to participation. To ensure our Extreme and Family Adventures are accessible to all, we established our Empowerment Fund,* a subsidy program designed to remove financial barriers.

Subsidies are available to an individual or a parent/caregiver and a child and are based on the honour system.

*The Empowerment Fund is a program, not a separate fund.

Participant First Name *

Participant Last Name *

What clinic do you attend for your diabetes care? *

Home Phone Number *

Email Address *

Full Name of Parent/Guardian (If under age 18)

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