Little Warriors Prevent It! Group Booking Form
This request is in reference to the Prevent It! Workshop offered by Little Warriors.

Please submit your request 3-6 weeks in advance. The minimum requirements for a group booking is 10 people.

Group or Organization Name:
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Organizer's Name:
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Title
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E-mail Address
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Phone Number
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Secondary Contact Name
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Secondary Contact Phone
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Secondary Contact E-mail Address
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Full address (including city/town and postal code) of where the workshop will take place:
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Special parking or entrance details into the venue:
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Please provide three options for your preferred date for the workshop delivery. If you would like to book more than one session at your location please let us know.
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Please provide your preferred time frame
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Total number of expected participants (minimum 10, maximum 30)
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Is this workshop open to the public within your community or is it closed exclusively for your group?
If it is open to the public, would you like assistance with the following complimentary options (select all that apply):
The Prevent It! workshop includes DVD segments. The organization understands that they are responsible for providing and testing all technical equipment prior to the workshop delivery date. The Little Warriors representative will not be responsible for operating the equipment. The organization will have someone on site to operate the technical equipment. If equipment fails, the workshop delivery will be postponed. Please ensure that the equipment is suitable for the venue and the number of expected participants (ie size of speakers and TV) If you choose to utilize a laptop and projector, please ensure suitable speakers are on hand and tested prior to the workshop. Please note the equipment you will provide for the workshop:
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I understand that we are to provide and test all technical equipment prior to the workshop start time
Required
The group understands that children and/or adolescents under the age of 18 are not permitted to participate within the Prevent It! workshop. The group further understands that children and/or adolescents under the age of 18 are not permitted access within the vicinity of the room/facility where the workshop is set to take place. Should children have access to the facility within the workshop delivery time frame, a room with a closed door (sound protected) is required.
Required
The group understands that if a facilitator is required to travel to a venue that is outside of designated areas a fee of $0.44/km will apply. Per diem rate, accommodations, shipping of materials and a food allowance may also apply.
Required
The Little Warriors Prevent It! workshop is offered to groups and organizations free of charge to ensure this important prevention information is available to everyone. The estimated costs to Little Warriors to train each individual is $40 per person. It is requested that your organization considers making a donation or providing an honorarium to Little Warriors of an amount you are comfortable with, to enable us to continue to deliver Prevent It! to future participants. Would your group or organization be in a position to make a donation/honorarium to Little Warriors?
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Approximate Amount:
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Notes, Questions, or Further Comments:
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