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Triple P Registration Form

REGISTRATION FORM
Please complete our registration form to sign up for one (or more) of our Positive Parenting Workshops by filling in your information in the fields below.
WORKSHOP #1: THE POWER OF POSITIVE PARENTING (Thursday, May 12th)
WORKSHOP #2: RAISING CONFIDENT, COMPETENT CHILDREN (Thursday, May 19th)
WORKSHOP #3: RAISING RESILIENT CHILDREN (Thursday, May 26th)
Each of the above workshops is scheduled from 6:30 - 8:00pm and is hosted online through WebEx.
Learn more about Parent & Caregiver Support Services (PCSS) and the wide array of free, universal parent education programs, workshops, information, and resources available to Chestermere parents! Click on the website link: http://www.chestermere.ca/pcss
First Name*
Last Name*
Phone Number*
Email Address*
City or Town of Residence*
Postal Code*
POSITIVE PARENTING WORKSHOP SELECTION(S):*
Please indicate which workshop(s) you will be attending by checking off the appropriate boxes:
1. Workshop 1 - The Power of Positive Parenting
2. Workshop 2 - Raising Confident, Competent Children
3. Workshop 3 - Raising Resilient Children
4. I WOULD LIKE TO ATTEND ALL 3 OF THE ABOVE WORKSHOPS
I will be attending the workshop(s) as a:*
Please select those that apply
1. Parent
2. Caregiver
3. Step Parent
4. Foster Parent
5. Grandparent
6. Other
Will someone else be joining you for this workshop?*
1. Yes
2. No
If yes, what is their relationship to you?
For example a spouse, parenting partner, friend, or another family member.
What is the name of the person joining you?
Are there any specific topics or information that you would like our facilitators to focus on?
Each workshop has a resource package with helpful handouts. We request that participants come to City Hall to pick up your resource package(s). *
1. I understand that I will need to come by City Hall to pick-up my resource package(s)
We will send you an email during the first week of May to confirm the pick-up date and the hours of operation.
Please click the box above to confirm your understanding.
Family Demographics
The information collected in this section is used to report back to our funders. Any question with an asterisk (*) is mandatory to complete.
Were you born in Canada?*
1. Yes
2. No
If you were born in Canada are you:
1. Indigenous
2. Francophone
3. None of the above
If you were NOT born in Canada, have you lived here for less than 3 years?
1. Yes
2. No
If you have lived in Canada for less than 3 years, where did you live before moving here?
Total Number of Children or Youth *
Please tell us how many children or youth that you care for.
Were your children or youth*
1. Born in Canada
2. Born outside of Canada
3. Born in Canada and outside of Canada
If born in Canada are your children or youth
1. Indigenous
2. Francophone
3. None of the above
If not born in Canada, have any been in Canada less than 3 years?
1. Yes
2. No
If applicable, how many have been in the country less than 3 years?
Date of Birth (1st Child)*
Date of Birth (1st Child)
Date of Birth (2nd Child)
Date of Birth (2nd Child)
Date of Birth (3rd Child)
Date of Birth (3rd Child)
Date of Birth (4th Child)
Date of Birth (4th Child)
How did you first hear about this workshop series?*
1. The PCSS Facebook Page
2. The PCSS Website
3. The Chestermere/Strathmore FRN Newsletter
4. The City of Chestermere's Events Calendar
5. A poster in the community
6. A friend or family member
7. A local agency or service provider (e.g. your family physician)
8. Other
If you selected 'other' from the options above
Please let us know where you first heard about this workshop series
Were you referred by an agency or service provider?*
Please select one of the following options:
1. Yes
2. No
3. I don't know
If yes, please provider the following information:
Name of referring agency or service provider,
Name of the individual helping you,
Contact information of individual (phone number or email)
Please note that we don't send confirmation emails after you have submitted this registration form.
We will get in touch through email approximately 24 - 48 hours before the workshop is scheduled to begin, which will include the link as well as instructions to join our session online using the WebEx application.

If you do not see an email, please check your Junk Mail.
Freedom of Information & Privacy (FOIP)
The personal information is being collected for activities related to the Parent & Caregiver Support Services (PCSS) program, workshop, seminar, and/or group activity and as such is deemed to be an activity of the City of Chestermere. The personal information is collected under the authority of Section 33(1)c of the Freedom of Information and Protection of Privacy Act, and will be used only for the purpose identified. If you have any questions or concerns about the collection or use of information you may contact the FOIP Coordinator at City Hall, 105 Marina Road, Chestermere, AB T1X 1V7 or call (403) 207-7050.

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Triple P Registration Form

Please note that we don't send confirmation emails after you have submitted this registration form.

We will get in touch through email approximately 24 - 48 hours before the workshop is scheduled to begin, which will include the link as well as instructions to join our session online using the WebEx application.

If you do not see an email, please check your Junk Mail.