2023 Drop In Registrations

Personal Information

• * First Name:
• * Last Name:
• * Email Address:
• * Confirm Email Address:
• * City:

• Please avoid spaces in the postal code

• * ZIP Code:
• * Phone:
• Birth date (For statistical purposes) Month, day, year

• How did you hear about us?

  • Email from SWFIC
  • Internet Search / Website
  • Social Media
  • Friend
  • Social Services
  • Daycare Centre
  • Email from School
  • Other Resource Centre

Family Registration for anyone who will attend

• Other Parent's First Name (if applicable)
• Other Parent's Last Name (if applicable)
• Other Parent's Birth-date (if applicable, for statistical purposes) Month/Day/Year
• Child's Name (first and last, if applicable)
• Child's Birth date (month day year, for statistical purposes)
• Child 2 Name (first and last, if applicable)
• Child 2 Birth-date - Month/Day/Year
• Child 3 Name (First and last, if applicable)
• Child 3 Birth-date (month day year)
• Please list additional children or family members who may attend with names and birth-dates (month day year)
   characters remaining

Cancellation Policy and Terms of Agreement

• For all SWFIC programs: I hereby understand that injuries can arise from the very nature of the program's activities, and hereby release and waive all rights to any claim or action against South Winnipeg Family Information Centre, Inc. and/or its representatives arising from injury, loss, or damage to me or my child's person or property, except where such injury, loss, or damage is caused by the negligence of South Winnipeg Family Information Centre, Inc. and/or its representatives.

• Participant/ Parent/Guardian: Please enter your name in the blank field below to indicate your acceptance of the terms of agreement

Guest Information

You may add a maximum of 1