Localife Toronto - Summer 2019

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Hello! Welcome to Localife Toronto. Completion of this form will help you to join in on awesome Localife events by Young Adult Cancer Canada.

Email *

Last Name *

First Name *

Preferred Name

Date of Birth *

YYYY

Gender *

Female

Male

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Other:

Connection to Cancer *

I have received a cancer diagnosis (have not filled out this form before)

I am a supporter to someone with a cancer diagnosis (have not filled out this form before)

I have received a cancer diagnosis (have filled out this form before)

I am a supporter to someone with a cancer diagnosis (have filled out this form before)

Connection to YACC *

I have previously attended Localife events in Toronto

I have previously attended Localife events in another city

I have previously attended a YACC Survivor Conference

I have previously attended a YACC Retreat Yourself

I have previously attended a YACC Retreat Yourself Adventure

I belong to the YACC secret Facebook group

New to YACC!

Other:

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