Block Party Registration Form

Required Applicant Information:

Contact Name: *

Address of the Block Party: *

Contact Phone Number: *

Contact Email Address: *

Block Party Date Requested/Time: *

Month

Day

Year

Start Time

Hour

:

Minute

am

pm

End Time

Hour

:

Minute

am

pm

Rain Out Option Date: *

Month

Day

Year

I you require a Temporary Road Closure, please fill out this form and return a minimum 14 days before the event.

Food Being Offered: *

Potluck (Shared Dishes for Everyone)

BBQ (Shared BBQ Dishes for Everyone)

Picnic (Supply Food for Your Own Family)

Catered (Food Supplied by a Catering Company)

Request for First Responder Attendance:

RCMP

Community Peace Officer (CPO)

Fire Services

Please fill out the Block Party Signup Sheet. A minimum 25% of the area blocked must sign-up on the agreement.

Number of Households Invited: *

City of Leduc Item's Available at Request:

How many Barricades do you require (1 per each lane of traffic): *

You can pick up your barricades from the City of Leduc Operations Building.

Number of Picnic Tables requested ($20/each): *

Additional Notes:

Collection and use of personal information
Personal information is collected in accordance with section 3 of the Municipal Government Act and section 33 (c) of the Freedom of Information and Protection of Privacy Act (FOIP) and is protected by FOIP. If you have any questions about the collection and use of the information, contact the City Clerk’s office at 780.980.7177 or at #1 Alexandra Park, Leduc, Alberta T9E 4C4