South Vancouver Family Place Participant Registration Form

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Please complete this form to participate in any of the South Vancouver Family Place Society Programs in all our locations. The Participant fee is $20 per year.
Registered families may participate in the Family Place drop-in , Fraserlands Drop-in, Parenting Education and Early Literacy programs and other activities. Visit our website for information on all services. www.svfp.org

Email *

NEW REGISTRATION

REGISTRATION RENEWAL

Last Name *

First Name *

Contact Information

This information is kept confidential and will be used only for SVFP purposes, by SVFP staff.

Phone Number *

Street Address *

City *

Postal Code *

Age range *

less than 30 year old

30-45 years old

46 to 60

61 or more

Select location You wish to attend? *

Family Place at Nanaimo St

Fraserlands Drop-in

Required

How many years have you lived in Canada? *

Less than 5 years

more than 5 years

I was Born in Canada

How many children under 5 years old will be attending with you? *

Other:

What are names of your child/Children? *

Your relationship with the child/Children *

Parent/s

Grandparent

Aunt/Auncle

Caregiver/nanny

Other:

Required

Are you parenting with *

With a spouse

Single parent

Guardian

Other:

First Language spoken at home *

English

French

Option 3

Japanese

Tagalog

Urdu

Hindi

Mandarin/cantonese

Spanish

Vietnamese

Korean

Other language please write below ..

Other First Language spoken at home (please specify) *

Do you identify as First Nation? *

yes

Photo/Video consent

This means that Staff may take Photos during Programs. Photos or videos may be used in our social media and website. Should you have any questions, Please speak to a staff member when you attend programs.

Yes

South Vancouver has a $20.00 Annual Participation Fee

We ask that participants contribute $2.00 every time you visit the Family Drop-in Program. Your contribution helps to cover the cost of materials and supplies that our centre uses.

Thank you for your understanding.

You can pay in-person when you come to our Family Drop-in Program .

Donation (Optional)

South Vancouver Family Place is a non-profit Society that relies on donations and grants to keep providing you with quality programs. All donations go directly towards programs.

Visit this link to donate: https://www.canadahelps.org/en/dn/12807

Thank you.

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