Workshop Registration Form
First and Last Name
Email
Workshop
How many adults will be participating in this workshop?
Age range
18-24
26-34
35-64
65+
Phone
Postal Code
Please check if the following applies to you:
Indigenous
Single Parent
Low Income Family
Non Indigenous Person of Color/Racialized Individual
What is your mobility status:
Non-migrants
Internal Migrants (from within Canada)
External Migrants (from outside of Canada)
Gender Identity (optional). I identify as:
Female
Male
Other
How long have you lived in Canada?
Do you have any concerns about your family functioning (i.e. new baby, job loss, parents back to work, etc.)? How has your family been impacted by COVID-19? What challenges is your family facing, if any?
How do you feel City West could provide you the support you might need in regards to parenting/child development/family functioning/etc. What are you hoping to gain from this workshop?
Do you have any concerns about your child's health or development?
Comments
Register