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Genesis Place booking request form

Organizer information

Contact name

Organization name

Phone number

Alternate phone number

Address

Postal code

Booking information

Booking confirmation

Scheduling and availability

I understand that submitting a booking request does not guarantee availability for my preferred date and time and that I will be contacted directly to confirm scheduling and finalize reservation details.

Verification

Name

Date

Signature I acknowledge that [by displaying/typing my name above], I am signing this application, and I agree to be bound as if I had endorsed this document with my own handwritten signature.

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Protection of Privacy Act (POPA)

The personal information on this form is collected under the authority of Section 4(c) of the Protection of Privacy Act (“the Act”) and will be used solely for the administration of City of Airdrie booking requests.

It will be treated in accordance with the Collection of Personal Information provisions (Part 1, Division 1) of the Act. Questions concerning collection of this information can be directed to the City of Airdrie at 400 Main Street SE, Airdrie, AB T4B 3C3 or 403.948.8800.