look n book - Application Form    
   
To register for programs online or by phone, you require an individual client number and family pin. To obtain this information, complete the online form below. You will receive an e-mail from The City within 3 business days, informing you of your Client Number and Family PIN. Keep this information handy for future registrations.

Birthdate: Birthdates are required for anyone UNDER the age of 18 to ensure program participants meet age requirements. Adults (those over 18) may provide birthdates OR enter ADULT in the birthdate space.


Additional Information: Please provide any information regarding family* members that may be helpful to staff, such as allergies, medication and disabilities.

*Family: Consists of up to two adults and their children/youths under 18 that are living in the same residence. Proof of legal guardianship may be required.

* Indicates a required field

Main Contact

* Last Name * First Name * Gender  * Birthdate (dd/mm/yyyy or ADULT)
    M   F  
* Mailing Address

* City

* Province * Postal Code
 
* Home Phone Business Phone * email Additional Information


* Retype email

Emergency Contact

 		   
Name Phone

Family Member 2
Last Name First Name Birthdate Gender Business Phone Additional Information

M    F


Family Member 3
Last Name First Name Birthdate Gender Business Phone Additional Information

M    F


Family Member 4
Last Name First Name Birthdate Gender Business Phone Additional Information

M    F


Family Member 5
Last Name First Name Birthdate Gender Business Phone Additional Information

M    F


Family Member 6
Last Name First Name Birthdate Gender Business Phone Additional Information

M    F


SUBMIT FORM

Please review the form before submitting. If you have additional family members, please complete and send a second form.


The personal information collected in this application is obtained under the authority of Section 33(c) of the Freedom of Information and Privacy Act section 3 of the Municipal Government Act and relates to and is necessary for an operating program or activity of this public body and is protected under the provisions of the Freedom of Information and Protection of Privacy Act. Further, this information may be used for marketing purposes specifically related to programs and service delivered directly for The City of Red Deer Recreation, Parks & Culture and will not be sold or shared with an individual or organization, except with the consent of the individual or organization as required by law. If you have questions about the collection and use of this information please contact the Recreation, Parks & Culture Manager, City of Red Deer, 4914 - 48 Avenue, Red Deer, AB T4N 3T4, by phone at 403-342-8159 or e-mail at looknbook@reddeer.ca