Refer a Child

If you would like to refer a child to our program, please forward the following information (also see Who Qualifies):

Note: Referrals cannot be made anonymously. We will not proceed without the prior knowledge and approval of the family involved. Please get the family's permission before making your referral.


Your first name
Your last name
Your Relationship to the child you wish to refer:
	Parent / Guardian
	Friend / Relative
	Medical Profession
	Self (potential dream child)

Your Street Address
City
Province
Postal Code
Telephone
E-mail
Child's first name
Child's last name
Parents' first name(s)
Parents' last name
Parents' phone number

If you have any questions, please contact us for more information:
The Rainbow Society
303-1 Wesley Avenue
Winnipeg, MB R3C 4C6
Phone: (204) 989-4010 Fax: (204) 944-9549
Toll Free: 1-866-989-4010
E-mail: rainbow@therainbowsociety.com

Refer a Child

More Information: