Strengthening Families Registration

Strengthening Families Registration
Do you consent to your information being collected for Strengthening Families program purposes only? Our purposes are to contact you regarding workshops, gather statistics, and ensure that our services are geared towards our demographic.*

YesNo
Name*

First NameLast Name
Birthdate

YearMonthDay
Date
Email*
example@example.com
Can we email you in regards to the workshops you are registered in?*

YesNo
Phone Number*
Please enter a valid phone number.
Can we call you and leave a voicemail in regards to workshops you have registered in?*

Yes to call and voicemailYes to call, no to voicemailNo
Gender (information collected about gender will be used for the purpose of addressing you correctly and will not decrease the quality of services or the respect you receive from Strengthening Families staff. We also ask for your gender for our statistics)

FemaleNon-BinaryMalePrefer not to sayOther (if comfortable please explain)
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Are you Indigenous? (information collected about Indigeneity is for statistical purposes and will not decrease the quality of services or the respect you receive from Strengthening Families staff.)

YesNoPrefer not to say
If so, are you:

First Nations (Status and Non-Status)InuitMétisOther
Were you born in Canada?

YesNo
What is your country of origin?
Approximately how long have you lived in Canada?
Is your family currently engaged in the family justice system?

YesNo
Is your family currently accessing the supervised parenting time monitored exchange services at YW Calgary, or another agency, organization, or provider?

YesNo
Are you comfortable with your ex-partner attending the same workshop as you?*

YesNo
If not, what is their name? Are there any safety concerns or protection orders in place?
How did you hear about Strengthening Families?
If other, please specify
Which workshops would you like to register for? (Select all that apply)

Wednesday, September 27 @ 10:00am - Strides ForwardWednesday, September 27 @ 1:00pm - Understanding InfluencesThursday, September 28 @ 1:00pm - Early ExperiencesThursday, September 28 @ 6:30pm - What to Expect: Supervised Parenting TimeSaturday, September 30 @ 10:00am - Recognize and RespondWith AHS: Wednesday, October 4 @ 6:30pm - Understanding Influences: Family Conflict and the Developing BrainThursday, October 5 @ 1:00pm - Talking to Children about DivorceThursday, October 5 @ 6:30pm - Changing Families: The Divorce ActFriday, October 6 @ 10:00am - Creating ConsistencyFriday, October 6 @ 6:30pm - Strides Forward: Co-ParentingWednesday, October 11 @ 10:00am - Recognize and RespondWednesday, October 11 @ 1:00pm - Early ExperiencesThursday, October 12 @ 1:00pm - Taking CareThursday, October 12 @ 6:30pm - Understanding InfluencesSaturday, October 14@ 10:00am - Talking to Children about DivorceSaturday, October 14 @ 12:00pm - Changing Families: The Divorce ActWednesday, October 18 @ 6:00pm - Creating ConsistencyWednesday, October 18 @ 7:15pm - Strides Forward: Co-ParentingThursday, October 19 @ 1:00pm - Recognize and RespondThursday, October 19 @ 6:30pm - Early ExperiencesSaturday, October 21 @ 10:00am - Taking CareSaturday, October 21 @ 12:00pm - Understanding InfluencesWednesday, October 25 @ 10:00am - Talking to Children about DivorceWednesday, October 25 @ 1:00pm - Changing Families: The Divorce ActThursday, October 26 @ 1:00pm - Creating ConsistencySaturday, October 28 @ 10:00am - Strides Forward: Co-ParentingSaturday, October 28 @ 12:00pm - Recognize and Respond
Would you like to be included on the email list to be sent ongoing program information and updates about Strengthening Families?

YesNo
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