Thank you for taking the time to register. Please fill out the form below an we will add the information to our database.

You will receive a confirmation email with the information you provided.

BASIC INFORMATION
Name (*)
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Nickname(s)
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Date of Birth (dd/mm/yyyy) Gender
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Spoken Language(s)
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Address
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 ,ON  
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PHYSICAL DESCRIPTION
Height Weight Eye Colour Hair Colour
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 ft  
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 in  
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 lbs  
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Race Complextion
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IDENTIFYING FEATURES
Scars, Birthmarks, Tattoos, Hearing Aids, Glasses, etc. (Location & Description)
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MEDICAL INFORMATION
Allergies
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Medication
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Results of Not Taking Medication
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Medical Condition(s) (Diagnosed or not)
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Family Doctor
Name Phone Number
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Other Doctor's
Name Phone Number
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Name Phone Number
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Name Phone Number
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POTENTIAL PLACES TO LOOK
1.
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2.
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3.
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4.
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5.
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EMERGENCY CONTACTS
CONTACT 1
Name
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Address
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 ,ON  
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Home Phone Cell Phone Other Phone
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Relationship To Person
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CONTACT 2
Name
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Address
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 ,ON  
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Home Phone Cell Phone Other Phone
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Relationship To Person
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CONTACT 3
Name
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Address
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 ,ON  
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Home Phone Cell Phone Other Phone
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Relationship To Person
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OTHER HELPFUL INFORMATION
1.
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2.
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3.
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4.
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5.
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Photo of Individual (5mb max)
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Email Address(*) (this is to email you a copy of this submission)
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