Required fields are marked with asterisks (*)

Request access to the sport court equipment

Please use this form to request access to the locked equipment bins located at the Coldwater Fairgrounds and Washago Centennial Park.

Name

Email:

Phone number:

Street address

Municipality

Province

Postal code

Please select the location that you are requesting access to the equipment bins at:

Coldwater Fairgrounds sport courts

Washago Centennial Park sport courts

Privacy statement

Information contained on this form is collected under the authority of the Municipal Act for general municipal operations. Information collected will be used and managed by the Township of Severn in accordance with the Municipal Freedom of Information and Protection of Privacy Act. If you require additional information, please view our Freedom of Information and Routine Disclosure Policy.

Acknowledgment

By completing and signing this form, you agree not to share the code provided with anyone and understand that you are responsible for returning all equipment to the bin when finished. Any damages as a result of the equipment not being secured after use or left out is the responsibility of the undersigned.

Signature

Clear

Date

Forms

Request access to the sport court equipment

Privacy statement

Acknowledgment