Event Name: * Event Date: Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 Year Year20212022202320242025 Event Location: * Venue Type: Public Park Street Festival Community Centre Other Other: Event Duration: 1 day 2-3 days 4-7 days Total Attendance: Under 800 Over 800 Annual Event? Yes No Organizer/Contact Information Organizer/Contact Person: Address: City/Town: Postal Code: Home Phone: Business Phone: Cellphone: Email Address * Website: Responsibilities of Organizer Water Supply Potable water supplied to vendors? Yes No Water Source: Municipal Other Regulated Source Bottled Water Private Well Water Truck Other (Specify Below) Other (please specify) Ice Supplied to Vendors? Yes No Source of Water Used to Make Ice: Hydro Electricity Available? Yes No Back-up Power Available? Yes No Sanitary Facilities Organizers are required to have toilets available for attendees. For recommendations on the number of toilets please contact your local sewage hauler. Permanent toilets Yes No If yes, how many? Location: Portable Toilets Yes No If yes, how many? Sewage Hauler: Portable Hand Wash Basins? Yes No If yes, how many? Permanent Hand Wash Basins? Yes No If yes, how many? Hand Sanitizer Provided Yes No Soap and Paper Towels Provided Yes No Garbage Will you be providing garbage collection? Yes No Vendor Information Are food vendors participating? Yes No Vendor(s) Name/Phone Number: Personal Service Setting Booth(s) (piercing, tattoo, manicure, etc)? Yes No If yes, vendor(s) name and phone numbers: Will any Vendors have a petting zoo or animal exhibit? Yes No If yes, vendor(s) name and phone numbers: Total Number of Vendors Participating: The information on this form is collected under the authority of the Health Protection and Promotion Act in accordance with the Municipal Freedom of Information and Protection of Privacy Act and the Personal Health Information Protection Act. This information will be used for the delivery of public health programs and services; the administration of the agency; and the maintenance of healthcare databases, registries and related research, in compliance with legal and regulatory requirements. Any questions about the collection of this information should be addressed to the Chief Privacy Officer at 1-800-265-7293 ext 2975.