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Registration - Black Youth Outreach United Program
Completing this form indicates your interest in registering yourself or your child (must be a Toronto resident 12-18yrs) to participate in the Black Youth Outreach United (B-YOU) program offered by CTO Child & Youth Educational Services for the Winter 2025 cohort. Please note, you will be contacted by a staff member to confirm enrollment into the program. 
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Email *
First Name  *
Last Name  *
Age *
Date of Birth (Month, Day, Year) *
Phone Number (Youth) *
Phone Number (Parent(s)/Caregiver) *
Email Address (Youth) *
Email Address (Parent(s)/Caregiver) *
Home Address (Where youth resides 75% or more of the time)  *
Postal Code *
Current School  *
Do you have any allergies/medical info that our staff should be aware of? If so, please explain. *
(1) Emergency Contact (full name, phone number, relationship to youth) *
How did you hear about this program? 
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Can our team contact you for further details and to provide additional information regarding the program?  *
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