Babies and Books

Rhymes & Books for Babies Registration

Tuesdays 10:15 to 11:00 a.m. Jan 23, 30, Feb 6, 13, 20, 27
Free Program for parents with babies and toddlers (siblings welcome). Please plan to attend all the sessions if you register. Of course, please stay home if your family is ill. Thank you.
How did you learn about this program?*

invitation in Newborn Bag from AHSsocial mediawebsite www.edsonlearning.caposterfriend / familyreferral from: ______________________________________
Name*

First NameLast Name
Phone Number*
Email*
example@example.com
Year of Birth?*
Gender*

FemaleMaleprefer to not disclose
Where do you live?*

Town of EdsonRural / Yellowhead County
Will you travel more than 50 km to attend?

YesNo
What is your status in Canada:*

Canadian CitizenPermanent Resident / Temporary Foreign Worker RefugeeFirst Nations / Metis
Highest Level of Education Completed*

Up to Grade 9Did not graduate High SchoolHigh School Equivalency GEDHigh School GraduateSome Post SecondaryPost Secondary GraduateAttended School Outside of Canada
Do any of the following make it difficult for you to attend.

lack of transportationthe feelack of childcare (older siblings)other ______________________________
How old is your baby? Will there be older siblings?*
Disclosure

The information you give on this form is voluntary. We appreciate any information you wish to share. This information is being collected in order to contact you if necessary and for statistical information requested by our funders and partners. This information is protected by the privacy provisions of The Freedom of Information and Protection of Privacy Act and will only be used for reporting. Reports to Advanced Education (Government of Alberta) do not include your name.
Signature

Clear
Should be Empty:

Rhymes & Books for Babies Registration

Disclosure