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Play to Lead Registration
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Contact Information
Please complete the registration below.
Submission failed due to the following error(s). Please click on the error to bring you to that spot in the application:
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First Name
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Last Name
Preferred Name
This could be name used that is not on legal documentation but how the individual is known.
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Date of Birth
The age must be between 4 and 18.
Once you select the year of birth, click on the actual day in the calendar to select the right Date of Birth.
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Gender
Please Select
Agender
Genderfluid
Man/Boy
Non-Binary
Transgender
Two-Spirit
Woman/Girl
A gender not listed here
Prefer Not to Say
Preferred Pronouns
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In an effort to understand the diversity in our funding, please share if you identify with any of the following races or ethnicities.
Please Select
Arab (e.g. Syrian, Lebanese, Palestinian, Moroccan, Egyptian, etc.)
Black (e.g. Caribbean, African, Latin American, Black Canadian, etc.)
East Asian (e.g. Chinese, Japanese, & Korean, etc.)
Indigenous (e.g. Inuit, First Nations, Métis, Aboriginal person from outside Canada, etc.)
Latin American and/or Hispanic (e.g. Mexico, Puerto Rico, Caribbean, South American, etc. )
South Asian (e.g. Indian, Pakistani, Sri Lankan, etc.)
Southeast Asian (e.g. Vietnamese, Cambodian, Laotian, Filipino, etc.)
West/Central Asian and/or Middle Eastern (e.g. Iranian, Afghan, etc.)
White (European descent)
Mixed Race (Please specify)
Prefer to self describe
Child doesn’t identify with any of the above
I do not wish to provide that information
I am not comfortable providing that information
Address
Address 2
City
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Alberta
British Columbia
Manitoba
New Brunswick
Newfoundland and Labrador
Northwest Territories
Nova Scotia
Nunavut
Ontario
Prince Edward Island
Quebec
Saskatchewan
Yukon
Province or Territory
Postal Code
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Phone Number
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Email
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Confirm Email
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Preferred language
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English
French
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