Required fields are marked with asterisks (*)

Community Group Recreation Affiliate Application

Organization Contact Information

Please provide us with some contact information for your organization or group. Haldimand County will require this information to be provided annually.

Organization or group name

Date of application

Organization or group website

Contact person for application

Phone

Alternate contact person

Alternate contact email

Alternate contact phone

Address (Please provide an address for the organization or a member of the executive)

Town/City

Postal code

Summary of Group Activities

Please provide a short summary of your group's planned activities.

Organization or Group Executive

Please list your current executive (if applicable):

Name

Position

Phone

Add Remove

Anticipated Operating Dates

Anticipated season start date

Anticipated season end date

Facilities and Services Requested

Use of Schools

Will your group be contacting the Grand Erie District School Board or the Brant Haldimand Norfolk Catholic District School Board for use of their facilities?

Grand Erie District School Board

Brant Haldimand Norfolk District School Board

None of the above

Marketing and Advertising

Haldimand County offers a monthly resident newsletter as well as often receives inquires from the public on recreation opportunities. Do you consent to have your information shared to the public?

Yes, please provide our information to the public.

No, do not provide our information to the public.

Notice of Collection

Personal Information contained on this form is collected under the authority of the Municipal Act, 2001, as amended and will be used for the purpose of processing this application/request. Questions about this collection may be directed to the Community Development and Partnerships at 905-318-5932 or recreation@haldimandcounty.on.ca.