Family Place's Program Registration Form

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Please complete this form to register for our programs. If you wish to register for an additional program(s) simply submit another form or comment in the comment section.

If you are interested in registering for our New Beginnings Prenatal Classes, please also email: familyplace@eastlink.ca to obtain a registration package.

If you would like more information about our programs and services please call 436-1348, visit us at: www.familyplacepei.com or our Face Book group: www.facebook.com/groups/familyplace or Facebook Page: www.facebook.com/familyplacepei

Completion of this form does not constitute successful registration. You will receive an email confirming your registration or placement on a waitlist. If you do not receive an email, please email us at: familyplace@eastlink.ca

Important:
During Covid, some of our staff work from home so please email us (familyplace@eastlink.ca) rather than leave a phone message.

Email *

Untitled Title

Parents/ Guardians Alternate Email

Parents/ Guardians Name (Mother/ Father) *

Please include mothers/ guardians full name. Example, MacDonald, Mary

If Pregnant, your Due Date *

First name followed by Age

Prenatal Classes - Important

Please ALSO email familyplace@eastlink.ca to get a registration package.

Children's Names, Age & DOB *

First name followed by Age

Parents/ Guardians Phone Number(s) *

List contact information for both mother/ guardians here. For example, 436-1234 (h), 888-1234 (w), 954-1234 (C)

Parents/ Guardians Mailing Address *

Program(s) Registering For *

Prenatal Classes (New Beginnings) Wednesday's 6:30-8:30 pm via Zoom

Full Circle Family Doula Program (Birth, Postpartum & Parenting Support)

Postnatal Program (Beyond the Bump) Thursday's 9:30-11:00a.m. at Family Place

Play Groups (Rock & Talk - Mon, Kensington - Wed, Borden-Carleton- Fri or Summerside - Fri)

Reggio Kids Pre-K and Preschool Program - Mon, Tue, Wed, Thur & Friday 12:45-3:45 p.m. at Family Place

Parenting Program or Workshop (Triple P, Nobody's Perfect, Positive Discipline, Handle With Care, etc. Tuesdays 6:30-8:30 pm vis Zoom.)

Breast Pump Loan and Attachments

Breastfeeding Support

Family Programs Tuesdays 9:30-11:00 am at Family Place (Mother Goose & Me, Wiggle Giggle & Munch, Baby Signs, ABC Music & Me by Kindermusik)

Healthy Living Programs (Fun Fit, Diaper Fit, Stroller Fit)

Stars & Strollers

Required

If you selected 'Parenting Program' above please specify which parenting program you are interested in (if applicable).

If you selected 'Playgroups' or 'Family Programs' or 'Healthy Living Programs' above please specify which program you are interested in (if applicable).

If you selected 'Reggio Kids' above please specify which program you are interested in: A: Mon @ Tue, B: Wed, Thur & Fri or C: Mon, Tue, Wed, Thur & Fri. To qualify for tuition subsidy from the Province for the 5 afternoon Pre-K program, your child must be 4 years old by December 31 and must be registered in the 5 afternoon per week program.

Additional Information or Comments

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