Dungeons & Dragons Social Anxiety Support Group Registration (Summer 2024)

Name*
Given Name Family Name
Student Number*
Email*
Phone Number
Birthday*
MM slash DD slash YYYY
Emergency Contact*
Relationship to You Given Name Family Name
Emergency Contact Phone Number*
The best way to contact me is by:*
- calling
- emailing
You are a/an:*
- domestic student
- Indigenous student
- international student
Are you able to attend all the dates of the group?*
- yes
- no
Are you registered for classes for the summer 2024 term?*
Only registered students qualify to join the group.
- yes
- no
What program are you enrolled in?*
What is your experience with social anxiety and loneliness?*
How experienced are you in playing Dungeons and Dragons? All levels welcome!*
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