Name of Participant (First)

Name of Participant (Last)

Commonly Used First Name (nickname)

Optional Demographic Questions

We are committed to creating a sport environment that is welcoming, inclusive, and accessible to everyone. The demographic information collected in this survey helps us better understand who is participating in our programs and where barriers to participation may exist.
This information will be used only in aggregate form to inform program development, improve accessibility, support equity, diversity and inclusion initiatives, and meet reporting requirements for funding and partner organizations. Individual responses will not be used to identify participants.

Gender - Select One - Man Non-binary Other Prefer not to disclose Woman

Do you identify as 2SLGBTQI+? - Select One - Yes No Prefer not to disclose

What is your population group (Select what is applicable)

Do you identify as First Nations, Métis and/or Inuk/Inuit? (Select what is applicable)

Are you a person living with disability? - Select One - Yes No Prefer not to disclose

What type of disability are you currently living with? - Select One - Prefer not to disclose Physical Mental Sensory Other

Impairment types that can be classified for Para Rowing. Select what is applicable Ataxia Atheosis Hypertonia Impaired muscle power Impaired range of movement Limb deficiency Other Vision impairment

Para-Rowing Classifications - Select One - PR1 PR2 PR3 I have not received an official classification

International Blind Sports Classification - Select One - B1 B2 B3 I have not received an official classification

Date of Birth

Date of Birth

Date of Birth