Life With Baby

Our Life with Baby classes are coming to you!

Life with Baby is a wonderful, interactive and informative series for parents. Each week we will begin with Mother Goose songs and rhymes. Together we will work through the Make the Connection teachings from Zero to Three. This program will also provide the opportunity for parents to meet with professionals in their fields; ask questions; gain valuable insights; network with other parents; share experiences and build confidence.

Questions? You can contact us as facilitator@empowersimcoe.ca

Location: Zoom (link will be emailed upon successful registration)

Maximum Number or Registrants: 30

Time of Course: 10:00 AM every Wednesday morning

For Parents and Children 0-12 months

1st Adult First Name: * Required
1st Adult Last Name: * Required
2nd Adult:
Contact Email Address: * Required
Contact Phone Number: * Required
Address * Required
Street Address City Postal Code
Child 1
First Name: * Required
Last Name: * Required
Date of Birth: Age Restriction - must be dd/mm/yyyy format * Required
Date Format: DD slash MM slash YYYY
Child 2
First Name:
Last Name:
Date of Birth: Age Restriction - must be dd/mm/yyyy format
Date Format: DD slash MM slash YYYY
Child 3
First Name:
Last Name:
Date of Birth: Age Restriction - must be dd/mm/yyyy format
Date Format: DD slash MM slash YYYY
Information, Authorization and Consent Form

This document indicates your consent to participate in distance-oriented group sessions with the Empower Simcoe EarlyON Program.

This document is designed to inform you about what to expect regarding confidentiality and other details concerning group participation. These group services will be delivered via technology-assisted media, such as telephone (landline and mobile devices), video conferencing, internet, tablet, PC desktop system or other electronic means using appropriate encryption technology.

Limitations of this virtual platform:
Please be aware that there is a risk of misunderstanding group members when communication lacks visual or auditory cues. There may also be a disruption to the service (e.g., phone cuts off, video lags or drops). This can be frustrating and interrupt the normal flow of group interaction.

Program Agreement:
• I will find a quiet and protected space to attend all group sessions.
• If I cannot attend the video session alone, I will be respectful of the privacy of other participants by wearing headphones.
• I will do my best to remain focused and limit distractions during sessions.
• If there is a loss of connection, I will attempt to call in using the number provided.
• I am familiar with utilizing video conferencing technology and/or agreed upon technology-assisted devices and will ask for assistance if required.
• I understand there are limitations to using virtual platforms and that it is not a complete substitute to the Programs offered by Empower Simcoe EarlyON.
• I understand that a virtual group has potential benefits including easier access to supports and the convenience of meeting from a location of my choosing.
• I understand there are potential risks to this technology which may include interruptions, unauthorized access, and technical difficulties.
• I understand that the EarlyON program facilitator can discontinue the group at any time if it is felt that the videoconferencing connections are not adequate.
• I am aware that group sessions may be recorded to be used for future learning opportunities.

EarlyON Child and Family Centre have a legal obligation to report abuse, neglect and exploitation that is reasonably suspected, disclosed or witnessed.
By checking the box of this consent, I am acknowledging that I have read, understand and agree with the above Program Agreement. Furthermore, it indicates my approval for my child (named above) to participate in Virtual EarlyON Programs. * Required
- I Agree
Please ensure are required fields (marked with *) are entered correctly.
Once form is submitted successfully you will be directed to a 'Registration Successful' page. If returned to this page, expand the program description once more to see which fields were missing/incorrect.

Please ensure are required fields (marked with *) are entered correctly. Once form is submitted successfully you will be directed to a ‘Registration Successful’ page and immediately receive an email confirmation. If returned to this page, please review the form to see which fields were incorrectly filled out.

Life With Baby

Child 1

Child 2

Child 3

Information, Authorization and Consent Form