Link! SRS – Kelowna "*" indicates required fields PARTICIPANT INFORMATIONName* First Last Please confirm the registrant is 19 years old or older* Yes No Gender*Preferred Pronouns*Diagnosis*CIty*Phone Number*Email* Does the participant exhibit any challenging behaviours that may prevent him/her from being in a group or participating in activities? (e.g., refusing to listen, hitting, screaming, and running away)?* Yes No Does the participant require 1:1 support within a group setting?* Yes No Does the participant communicate verbally?* Yes No Will the participant be available to attend all sessions?* Yes No Is the registrant aware of and/or comfortable learning about the following topics: healthy relationships, consent, sex safety, pregnancy, and pornography?* Yes No DATE/TIME/TOPIC DETAILS Mandatory Sessions for Participants (1:00–2:30 PM): Feb 4 – Consent Feb 11 – Rights and the Law Mandatory Session for Support People (9:00–11:00 AM): Feb 4 – Demystifying SexualityElective Sessions for Participants Feb 18 – Healthy Relationships Feb 25 – Types of Touch and Trusted People Mar 4 – Online Safety SOCIAL COACH INFORMATIONSocial Coach Name* First Last Relationship to Participant*Phone*Email* Please confirm the social coach is able to attend the mandatory social coach session* Yes No
Phone: (778) 945-1435 Toll Free: 1 (855) 437-7095
Email: laurel@posAbilities.ca
Phone: (778) 945-1435 Toll Free: 1 (855) 437-7095 Email: laurel@posAbilities.ca