Language in the Pool 2024 (Burnaby)

Join BC Family Hearing Resource Society’s Early Intervention Team for an opportunity to learn vocabulary and practice communication strategies to support language access in the pool environment. Please note this is NOT a swimming lesson. Full Parent/Caregiver participation is required to participate, with one adult there per child. Please come prepared to be in the water with your child. Cost for pool entrance will be covered by BCFHRS.

The time below is the start time of the event, so please arrive early enough to get you and your child changed into swimwear and at the gathering spot by the start time. Please also note that photos and cell phones are not permitted on the pool deck.

Wednesday, October 23rd, 2024, 1:00-3:00pm

Bonsor Recreation Complex
6550 Bonsor Avenue, Burnaby, BC V5H 3G4

Are you currently receiving early intervention services from BC Family Hearing Resource Society?*

YesNo

We’re sorry, this service is only being offered to BC Family Hearing Resource Society clients at this time. To inquire about registration for our services, please contact info@bcfamilyhearing.com

Child's Name*

First NameLast Name

Child's Birthdate*

Date

Child's Age Category and time slot*

0-up to 3 years (Wednesday, October 23rd, 2024, 1:00 - 2:00 PM)3-5 years (Wednesday, October 23rd, 2024, 2:00 - 3:00 PM)

Parent/Caregiver's Name*

First NameLast Name

Email Address*

example@example.com

Which Early Interventionist works with your family? If you don't know the name, please choose I don't know.*

I understand that the Language in the Pools program is NOT a swimming lesson, but rather an opportunity to learn vocabulary and communication strategies related to pool/water-based activities.

I understand that I am expected to fully participate in the pool and take full responsibility for the safety and well-being of my child while participating in the Language in the Pool program.

What type of hearing equipment does your child use, if any?*

My child is unaidedMy child uses both a hearing aid AND a cochlear implantMy child uses hearing aid(s)My child uses cochlear implant(s)

My child is unaided*

My child has a unilateral hearing difference (right-sided)My child has a unilateral hearing difference (left-sided)My child has a bilateral hearing lossMy child is a CODA

My child uses hearing aid(s)*

Unilateral (right-sided)Unilateral (left-sided)Bilateral

My child uses cochlear implant(s)*

Unilateral (right-sided)Unilateral (left-sided)Bilateral

My child's primary language(s) are*

Do you require a language interpreter to be present?*

YesNo

What language do you require an interpreter for?*

Is there anything that you want the Early Interventionist team to know about you or your child in anticipation of participating in this program?*

What are you most looking forward to learning/taking away from this program? *

We recognize that the pool is a very challenging communication environment, and for some, this may be your first experience in the water/pool environment. If you have additional questions or concerns about participating in Language in the Pools, please reach out to your Early Interventionist. We look forward to learning together in the pool!

General Photos and Media Use

Do you give us permission to record and use any photos, video, audio, or social media posts of you and your family?*

YesNo

I/We hereby voluntarily and without compensation authorize the use of the following media by the BC Family Hearing Resource Society of me/us and my/our child, along with any siblings that may attend sessions, groups or events.*

PhotographsAudio/Video recordingsSocial Media posts/content

I/We consent for these media to be used by the BC Family Hearing Resource Society in the following:*

General publicitySocial media posts/campaignsInformation brochures and pamphletsEducation and training materials for professionalsEducation and training materials for parents/families

Would you like to be contacted each time any of the media (as indicated above) of you, your child, or your family is used?*

YesNo

By signing below, I provide permission for the BC Family Hearing Resource Society to use the forms of media indicated above for the purposes indicated above.*

For any further questions, please email info@bcfamilyhearing.com or call (604) 584-2827.

We look forward to you joining us!

Language in the Pool (Burnaby) Registration