Event/Parade Permit Application

Event Information

Date of Event

Title of Event

Location of Event

Numer of Expected Participants

Type of Event

Celebration

Community Recognition

Fundraising

Other

Event Start Time

Event End Time

Do you require a Road Closure for your event?

Yes

Event Organizer Information

Name of Organization

Contact Name

Email Address

Phone Number

Mailing Address

Postal Code

Are you a Registered Chairty or a Not For Profit Organization?

Yes

Acknowledgements

Organization is required to pay all costs associated with the permit including but not limited to Pay-Duty Police Officers, rental of Police equipment, Town of Ajax staff, and required equipment & supplies (barricades, temporary washrooms, etc.).

I have read and understand.

Organziation is required to supply a Liability Insurance Certificate with the Town of Ajax listed as an additional insured in the amount of $2 or $5 million (depending on event & activities). Certificate must be provide to the Town 14 days prior to Event.

I have read and understand.

Application will be decided within 21 days of submission. Comments from the Town, Region of Durham, Durham Regional Police, Durham Region Transit, EMS, and any other agency deemed appropriate, will be taken into account regarding permissions granted.

I have read and understand.

Incomplete applications or applications with insufficient detail will result in delays in processing the application or may result in absolute cancellation of the application by the Town of Ajax.

I have read and understand.

Collection of Personal Information

Personal information collected on this form is collected pursuant to the Municipal Act, 2001, s. 11(1), and will only be used for the purpose for which it is collected, and will not be distributed or used by the Town of Ajax for any other purpose. Questions about this collection may be directed to the Town of Ajax Records and Freedom of Information Coordinator at 65 Harwood Avenue South, Ajax, Ontario, L1S 2H9 or 905-683-4550.

Learn more about the Town of Ajax's Privacy Policy.

Accessibility

If you require this form in an alternative format, please contact the Town of Ajax Accessibility Coordinator, at 905-683-4550, or by e-mail at contactus@ajax.ca.

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