Participation Intake Form

Baobab Black Seniors Care- Participation Form

We are delighted to welcome you to Baobab Black Seniors. Each gathering is a chance to share stories, wisdom, and joy while strengthening our bonds with one another. We invite you to join our activities, where we can connect, support one another, and build a stronger sense of community together. Your presence enriches our circle, and we look forward to spending this time with you.

We’d love for you to join us. Please take a few minutes to fill out this short form to let us know you’re interested in participating. Your responses will help us plan and make sure your experience is safe, comfortable, and enjoyable.


Participant Information


Emergency Contact


Health & Accommodations


Participation


Consent

I understand that Baobab Black Seniors will do their best to provide a safe and welcoming experience for Black Seniors in BC. I understand that my participation is voluntary and that Baobab cannot be responsible for accidents, injuries, or personal belongings. I will share any health or accommodation needs, with the understanding that the organizers will try their best, though not every request may be possible. I also understand that the information I provide will be used only for planning and safety by the organizers and will be kept private and confidential.