Event Registration Form I am interested in registering for:(Required)Youth Basketball Camp "13+ only" (15 Sep 2023 to 15 Dec 2023)Yoga for Senior Women (18 Nov 2023 to 20 Jan 2024)Start your career with the City of Winnipeg - An information session (14 Dec 2023)Youth Basketball Camp - Winter 2024 - 8 Sessions (12 Jan 2024 to 01 Mar 2024)Information for Participants: First Name(Required) Last Name(Required) Gender(Required)MaleFemalePhone(Required) Email(Required) Date of Birth(Required) DD slash MM slash YYYY Primary LanguageEnglishFrenchAmharicArabicBengaliChineseDariFarsi (Persian)FilipinoHindiKinyarwandaPashtoPunjabiSpanishSwahiliTagalogTigrignaUkrainianYiddishYorubaCountry of BirthCanadaAfghanistanAlbaniaAlderneyAlgeriaAmerican SamoaAndorraAngolaAnguillaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBophuthatswanaBosnia and HerzegovinaBotswanaBrazilBritish Virgin IslandsBruneiBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanary IslandsCayman IslandsCentral African RepublicChadChileChina (PRC)ColombiaComorosCongo (Congo Republic)Congo Democratic Republic ofCosta RicaCote d Ivoire (Ivory Coast)CroatiaCubaCyprusCzechia (Czech Republic)DenmarkDjiboutiDominicaDominican RepublicEast Timor (Timor-Leste)EcuadorEgyptEl SalvadorEnglandEquatorial GuineaEritreaEstoniaEswatini (formerly Swaziland)EthiopiaFijiFinlandFr. PolynesiaFranceFrench GuianaGabonGambiaGeorgiaGermanyGhanaGreeceGreenlandGrenadaGuadaloupeGuamGuatemalaGuineaGuinea-bissauGuyanaHaitiHoly See (Vatican City)HondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKampuchea DemocraticKazakhstanKenyaKerguelen IslandsKiribatiKorea, NorthKorea, SouthKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmar (formerly Burma)NamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNorth MacedoniaNorthern IrelandNorwayOmanPakistanPalauPalestinePanamaPapua New GuineaParaguayPeruPhilippinesPitcairn IslandsPolandPortugalPuerto RicoQatarReunionRomaniaRussiaRwandaSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaScotlandSenegalSerbiaSeychellesSierra LeoneSingaporeSlovakia (Slovak Republic)SloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSt. HelenaSt. Kitts and NevisSt. LuciaSt. Pierre Et MiquelonSt. Vincent And The GrenadinesStatelessSudanSudan, SouthSurinameSwedenSwitzerlandSyriaTaiwan (ROC)TajikistanTanzaniaThailandTibetTogoTongaTrinidad & TobagoTunisiaTurkeyTurkmenistanTurks & CaicosTuvaluU.S. Virgin IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited States of AmericaUruguayUzbekistanVanuatuVenezuelaVietnamWalesWestern SaharaYemenYugoslaviaZaire (now Congo DRC)ZambiaZimbabweCurrent Immigration Status in CanadaPermanent ResidentCitizen by BirthCitizen - NaturalizedGovernment Assisted Refugees (GAR)Provincial Nominee Awaiting PRRefugee Claimant (RC)Student - Study PermitUkraine CUAET PermitVisitor Visa - Temporary Resident VisaWork Permit - Live-in CaregiverWork Permit - International Mobility ProgramWork Permit - Post-Graduation Work PermitUCI# / PR Card Number (8 or 10 digits) Special Requirements/Considerations Allergies Carries Epi-pen Physical Disability Please specify any allergies or dietary restrictions you may haveMedical Conditions/MedicationsOther RemarksInvite Link Consent(Required) I understand that invitation links for online events, when applicable, will be sent to me later via the provided email address. (Required) Newsletter Subscription I would like to subscribe to receive emails and newsletters regarding updates on this event, as well as future programs and events. Photo Consent I authorize the staff to take photographs of me during this event and to display and otherwise use these photographs without charge, solely for the purpose of promoting and reporting on this event. HiddenFee Information Source (Admin Only)(Required)Youth will have the opportunity to practice and hone their basketball skills. ONLY 25 SPOTS IN TOTAL so register now! FEE INFORMATION: Payment can be made at the office by cash or credit card. etransfers can be made at info@healthymuslimfamilies.ca, in the message/note section mention basketball. Registrations are not guaranteed until the fee is processed. NOTE: The $25 fee only covers ONE participant. Healthy Muslim families cordially invite you all to be a part of this healthy activity. Be strong and active!Anyone seeking for a job or interested in working for the city of Winnipeg can attend this informative session."Youth will have the opportunity to practice and hone their basketball skills. ONLY 25 SPOTS IN TOTAL so register now! FEE INFORMATION: Please e-tranfer to: info@healthymuslimfamilies.ca NOTE: The $15 fee only covers ONE participant. Registrations are not guaranteed until the fee is processed AND the waiver form is signed "HiddenRemarks Placeholder (Admin Only)(Required)Would you like us to know something regarding your registration request?Would you like us to know something regarding your registration request?Would you like us to know something regarding your registration request?Would you like us to know something regarding your registration request?Would you like us to know something regarding your registration request?HiddenStaff to be Notified (Admin Only)(Required)youth@healthymuslimfamilies.ca,amna.iqbal@healthymuslimfamilies.ca sumera.aurangzeb@healthymuslimfamilies.ca,amna.iqbal@healthymuslimfamilies.caemployment@healthymuslimfamilies.ca,amna.iqbal@healthymuslimfamilies.cayouth@healthymuslimfamilies.ca,amna.iqbal@healthymuslimfamilies.caHiddenEvent-to-Program Mappings (Admin Only)(Required)0003000600070003HiddenProgram (Admin Only)(Required) HiddenStaff Email (Admin Only) HiddenDate Visited (Admin Only) DD slash MM slash YYYY HiddenRemarks (Admin Only)Allergies/Dietary Restrictions - None specified Medications/Medical Conditions - None specified Other Remarks - None specified
