METRAC
Respect in Action (ReAct) Booking Form

Thank you for your interest in ReAct. Please submit this form at least 24 business days before the requested date. If you would like to request more than one workshop, training, and/or speaking engagement, please submit a new form for each request.

General Information
*Contact name: *Contact title:
*Full organization/school name: *Organization/school mailing address:
Email address: Website:
*Phone number: Fax number:
Invoice: Yes, please send me an invoice METRAC email list: Yes, please add me to METRAC's email list


Booking Information
*I am requesting a ReAct (pick one):

Mini workshop for youth (1–1.5 hours, $75 fee)
Full workshop for youth (3 hours, $150 fee)
School Assembly (45 minutes–1.5 hours, $300 fee)
Training for educators, youth, or youth workers (you will be contacted about scope, length, and fee)
Speaker for a panel, event, or conference (you will be contacted about scope, length, and fee)
Don't Make Me Repeat Myself Youth Advocacy Training (minimum of 3 hours; you will be contacted about fee)

Cheques are to be made payable to METRAC (158 Spadina Road, Toronto, ON, M5R 2T8). Please note that for requests outside of the City of Toronto, additional fees will apply to help cover costs.
*Is this request a result of specific incidents of violence or abuse participants have experienced in the past 6 months?

No Yes

Note: If yes, we will follow up for more information.
*Please indicate your top three date and time options:
What topic is being requested? (Choose one topic per requested event. Please skip this section if you have already requested the Don't Make Me Repeat Myself Youth Adovcacy Training above.)

Speak Your Truth: Empowerment for Young Women (for girl-only workshops, assemblies, and trainings)
Going Beyond the Massacre: December 6th Remembrance (for workshops, assemblies, and trainings)
Why the Looks? Bullying Between Young Women (for girl-only workshops, assemblies, and trainings)
The Bully Factor (for workshops, assemblies, and trainings)
What’s Love Got to do With It? Dating Violence (for workshops, assemblies, and trainings)
Tough Guise: Masculinity (for boy-only workshops, assemblies, and trainings)
Ending the Silence: Violence at Home (for workshops and trainings)
What’s Love Got to do with it? Dating Violence for LGBTQ Youth (for workshops and trainings)
Only Yes Means Yes! Sexual Assault/Date Rape (for workshops and trainings)
Our Power, Our Privilege: Intro 2 Anti-Oppression (for workshops and trainings)
Feeding or Starving the Hype: Youth At-Risk and Violence (for workshops and trainings)
Speak Your Truth: Empowerment for Young Mothers (for girl-only workshops and trainings)
Love or Obsession? Stalking (for workshops and trainings)
Gender-Based Violence 101 (for workshops and trainings)
Additional comments about request and what you’d like to accomplish:


Information About Participants
*What number of participants is expected to be present? (Note: workshops/trainings may have no more than 30 participants. Assemblies may include up to 250.)
Minimum #:
Maximum #:
*Participant age range?
What grades are they in (if applicable)?
Genders?
# of females:
# of males:
# of Trans-identified:
How many are ESL learners?
How many are Deaf or hard of hearing?
If there are Deaf or Hard of Hearing participants in the group, are ASL (American Sign Language) interpreters available or present? Yes
No
N/A
How many are living with known disabilities?
Learning disabilities:
Vision disabilities:
Physical disabilities
Have participants ever been exposed to violence prevention workshops in this setting? Yes
No
If they have been exposed to a violence prevention workshop, please describe:
What issues do you think are prevalent in the lives of participants?
Anything else we should know about participants to ensure the event is accessible and relevant to them?


Information About Space and Equipment
*Can we re-arrange the setup of the space where the workshop/training/assembly/speak will be conducted?

No Yes
*How long before the workshop/training/assembly/speak may we arrive and where exactly should we go?
*Will a teacher or youth worker be present?

No Yes N/A

Note: ReAct’s activities are delivered for youth, by youth. We ask that teachers/youth workers be mindful of their participation and kindly respect the youth-centric nature of our events.
What materials or audio-visual equipment will be available for us to use during the course of the workshop/training/assembly/speak? (Choose all that apply):

Flipchart and markers
TV/DVD Player
Portable CD Player
Laptop/computer (with Quicktime and/or Windows Media Player), projector, and speakers
Access to internet
Other materials or equipment:
If necessary, will there be someone to assist us in the use of the audio-visual equipment?

No Yes
If yes, please provide the person's full name:
Please give directions to the event location by TTC and car:
Is there anything else you would like us to know for the planning and/or delivery of the event?