Event Reservation Form You are registering for: Important: This event is for participants who have previously completed our Caregiver DBT Group. If you have not completed our Caregiver DBT Group in the past but are interested in parent services and/or workshops, please click here to connect with us: tpwg.ca/connect/. Your Name(Required) First Name Last name Your Email(Required) Phone(Required)Please provide the age of the loved one you are supporting:(Required)Please share any questions you would like to discuss or be addressed in the workshop: Reservation and Payment InformationPlease note that your spot is confirmed once payment is received. After submitting this form, please follow the link provided to set up a credit card payment profile with our clinic. This will be used to process payment for the workshop and any further services you may wish to pursue. If you already have a credit card on file with us, please check the box below to provide consent for us to charge this card for your workshop attendance. Should you wish to pay via e-transfer, please send this to intake@tpwg.ca along with the submission of this form in order to secure your space. Payment preference:(Required) I already have a payment profile set up with TPWG and authorize you to charge my card for this workshop attendance I will set up a new payment profile (link on next page) I understand my reservation is only confirmed after payment is arranged.(Required) I agree Please note that the link to the workshop will be sent out the morning of December 12th. The registration fee is applicable per family (not per person). If you have any questions please don't hesitate to contact us at reception@tpwg.ca Thank you!
