2024-2025 Neighbourhood-Managed Ice Rink Application Form Thank you for your interest in hosting an ice rink in your neighbourhood! Before completing this application form, please take a moment to review the 2024-2025 Neighbourhood-Managed Ice Rink Program Guide The guide provides detailed information on protocol and procedures which will help you complete your application. PLEASE NOTE: Due to limited program capacity, not all rink applications may be approved. If you have any questions, please email neighbourhoodicerinks@london.ca or call 519.661.5336. Thank you! Question Title * 1. Contact Information for Lead Resident Name Address Postal Code Email Address Phone Number Question Title * 2. Are you applying as part of an incorporated group? (Incorporated organizations are clubs or community groups that are registered with the government) Yes No Unsure Question Title * 3. If yes, what is the name of your Corporation? Question Title * 4. Proposed Neighbourhood-Managed Ice Rink Location Park Name Location within the Park Question Title * 5. OPTIONAL: Feel free to upload an image of the exact location in the park where you would like to have your ice rink. PDF, DOC, DOCX, PNG, JPG, JPEG, GIF file types only. Choose File Choose File No file chosen Remove File OPTIONAL: Feel free to upload an image of the exact location in the park where you would like to have your ice rink. Question Title * 6. If your desired location is unavailable (or not suitable) do you have a secondary location where you would like to host the rink? Yes No Question Title * 7. If yes, which park did you have in mind? Question Title * 8. Have you participated in the Neighbourhood-Managed Ice Rink Program before? Yes, I have participated in this program in previous years. No, I have not participated in this program before. Question Title * 9. Do you have a water source secured? Yes No Working on it Question Title * 10. If yes, please describe your water source. Question Title * 11. Neighbourhood-Managed Ice Rinks require six (6) dedicated volunteers (18 years +). Please list the names of five (5) volunteers, in addition to yourself, who have agreed to support your outdoor rink. NAME: NAME: NAME: NAME: NAME: Question Title * 12. Please agree to the statements below to complete your application. I agree to the protocols and procedures as outlined in the guide The personal information collected on this form is collected under the authority of the Municipal Act, 2001, S.O. 2001, c. 25, and will be used to correspond with you. Questions about this collection should be addressed to the Manager, Neighbourhood Development and Support at Citi Plaza, 355 Wellington Street, Suite 248, PO Box 5045 London, ON N6A 4L6 Tel: 519-661-2489, email: jmartino@london.ca Done