Please fill out the following information to confirm your participation in the Rainbow Haven: Embracing Journeys program. Your responses are completely confidential. We understand that privacy is important, and we want to create a safe and inclusive environment for all participants. If you prefer to remain anonymous, please indicate using a preferred name.

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* 1. Name/Preferred Name:

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* 2. Email:

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* 3. Are you a part of the LGBTQIA+ community?

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* 4. Do you identify as a newcomer?

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