Register Your Agency Agency InformationAgency Name*Chapter Association*-- select a Location --CalgaryEdmontonHalifaxMontrealMontréalOttawaTorontoVancouverWinnipegMain Contact Name First Last Phone*Website Agency Address* Street Address Address Line 2 City AlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNorthwest TerritoriesNova ScotiaNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukon Province Postal Code Qualifying QuestionsAs the Agency or Organization representative I have read and fully understand the criteria as noted on the previous page.*AgreeDisagreeAs the Agency or Organization representative I fully understand that all nominated children for the flight will require a valid Canadian Long Form Birth Certificate.*AgreeDisagreeAs the Agency or Organization representative I understand that any child put forth can not have a parent or legal guardian that works for Air Canada or another airline.*AgreeDisagreeAs the Agency or Organization representative I understand that we will be required to participate in one of the local chapters fundraising events.*AgreeDisagreeAccount InformationName* First Last Email* User Name*Password* Enter Password Confirm Password Strength indicator PhoneThis field is for validation purposes and should be left unchanged.