Form Center

By signing in or creating an account, some fields will auto-populate with your information and your submitted forms will be saved and accessible to you.

Circle of Security Parenting (COSP)- Registration Form

  1. COSP Logo (transparent)
  2. COSP

    INSTRUCTIONS: Please provide your information in the fields below to register for our Circle of Security Parenting (COSP) program. Please ensure that you include a response for all fields with an asterisk (*).

    WHEN: This 8-week session runs on Thursday evenings from 7:00pm - 8:30pm from October 13th to December 15, 2022

    WHERE: Online through Webex

    PLEASE NOTE: This free, online program is for parents or caregivers of children from 0 to 6 years of age. 

    Participants will be asked to commit to all 8-weeks (8 sessions) to ensure a meaningful learning experience.

  5. Pronouns*
  6. We will be sending an email with the instructions to join virtually through WebEx as well as different resources throughout our time together.

  7. Do you have any allergies, dietary or medical conditions (including behavioral needs) that may might need to respond to during program?*
  8. Do you have any legal no-contact orders (ie. restraining orders) or other restrictions on contact we should be aware of?*
  9. Are there any current safety concerns we should be aware of?*
  10. Program Workbook - Language Options*

    Workbooks for programs are available in the following languages. Please select one from the options below:

    WHY DO WE ASK FOR THIS INFORMATION? The demographic information collected in this section is used for reporting purposes only as required by our funder. Any question with an asterisk (*) is mandatory to complete, but those without can be skipped.
  12. Were you born in Canada?*
  13. Do you self identify as:*
  14. If you were NOT born in Canada, have you lived here for:
  15. Please tell us how many children that you care for.
  16. Were your children:*
  17. How did you learn about this workshop?*
  18. E.g. Synergy, FCSS, Trellis, Healthy Families
  19. Thank you for taking the time to complete this form. We look forward to connecting with you!
  20. Freedom of Information & Privacy (FOIP)
    Your 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.
  21. PPSG logos
  22. Circle of Security
  23. Leave This Blank:

  24. This field is not part of the form submission.