395 Lakeshore Dr., North Bay, ON, P1A 2C5 | Phone: 1-833-236-0281 Ext. 1 csrc@united-church.ca
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2024 CSRC Regional Meeting In-Person Registration Form

Name(Required)
Please indicate your pronouns (for example: she/her, he/him, they/them)

Contact Information

Please ensure that your contact information and role has been updated in ChurchHub, either by yourself if you are ministry personnel, or by your community of faith administrator if you are an Elected Lay Representative. We use the information found in ChurchHub to check if you have voting privileges for this meeting. Thank you for your attention to this matter.

Consent(Required)
Canadian Shield Regional Council protects your personal information by adhering to all legislative requirements with respect to privacy. The collection of information on this registration form is for the purposes of Canadian Shield Regional Council only. Please be aware that photography and videotaping will occur at the regional meeting. Photos or videos of participants may, or may not, be taken during the event/activities. In turn these images may be published in print or posted online on our website, YouTube channel, photo galleries or used at the discretion of Canadian Shield Regional Council. By submitting this registration form you are indicating your consent to the collection and use of your information and photo and/or video for the use of Canadian Shield Regional Council.
Connection to Region(Required)
Please select your member connection to the region.

Please let us know what community of faith you are affiliated with and include a general location, such as Grace UC, Sudbury.
Workshop 1 - Saturday 1:15 -2:00 p.m.
Workshop 2 - Saturday 3:00 p.m - 4:00 p.m.
Workshop 3 - Saturday 4:15 p.m. - 5:15 p.m.
Other than English or French, please let us know what languages you speak fluently.
Read in Another Language During Worship
If you speak a language other than English or French, would you be willing to participate in that language during the meeting? For example, translate and then read a bible verse in Korean.
Name of Emergency Contact(Required)
Please list the name of who we should contact in the event of an emergency.
Please let us know if you have any accessibility needs we should be aware of.
Please let us know if you have any food allergies or dietary concerns that we should pass along to our caterer.
Meal Plan - Pay by Cheque
If you wish to pay for your Delegate or Guest Meal Plan by cheque, please make it payable to 'Canadian Shield Regional Council' and mail it to: Janet MacDonald, PO Box 1543, 696 Emma St., Port Elgin, ON, N0H 2C0

If you have any issues with paying online please contact Susan Whitehead at swhitehead@united-church.ca

The meal plan for the Regional Council Meeting includes buffet dinner on Friday and a buffet lunch and a sit down served supper on Saturday. Please indicate that you would like to purchase the meal plan by putting a "1" in the quantity box beside the price. If you DO NOT want to do the meal plan, please leave the quantity box blank.
Price: $ 40.00 CAD
If you are a guest attending the regional meeting, please note that this meal plan is not subsidized by the region and therefore is a higher amount. Please indicate that you would like to purchase the meal plan by putting a "1" in the quantity box beside the price. If you DO NOT want to do the meal plan, please leave the quantity box blank.
Price: $ 150.00 CAD

Thank you so much for registering for our 2024 Canadian Shield Regional Meeting. Please hit submit to complete your registration. A confirmation email will be sent to you shortly. Blessings!