Register With JWC
We are passionate about the experiences of our patients. Once you have completed the online registration form and our Client Care Team has entered your information into our system, you will receive an email with the next steps needed to finalize your registration with JWC.

If you run into any problems, please contact our Client Care Team at 1-888-594-4272, or by email at customerservice@jwc.ca.
Required fields are marked with a *
Personal Info
First Name
Last Name
Date of Birth
Gender
Your Email
Phone Number
Fax Number
Are you an existing JWC patient who is renewing?
Yes No
Are you a veteran?
Yes No
Primary Address
Street Address
City
Postal Code
Province
Is your shipping address different from your primary address?
Yes No
Is this a private address?
Yes No
Applicant Declaration
The following declaration should be signed either by the Applicant or the person responsible for the Applicant:
  • I hereby certify that the Applicant named herein is normally a resident in Canada.
  • I and/or the Applicant have read the “General Terms and Conditions” as published on the web site included in the “James Wagner Cultivation Network” (as therein defined) which I agree to incorporate into this document by reference, and to which I acknowledge that I am bound.
  • I further certify that information given in this application and in any appended documents (i.e. proof of legal name change) is both correct and complete.
Name
Date