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2. Date of Block Party*
   Date of Block Party
3. Approximate time*
   Approximate time
5. Location Address*
7. City
8. Province
9. Postal Code
11. Main Contact Name*
13. Email Address*
15. Phone/Cell Number*
17. Do you want to borrow the Block Party Activity Kit (contains a variety of games)?*

    1. Yes
    2. No
18. If yes for a Block Party Activity Kit, please contact us to arrange a pick up time.

    Contact Vanessa at 403-782-1278 or vaverill@lacombe.ca

20. Will you be requiring barricades to partially close down a lane?*

    1. Yes
    2. No
21. If yes for barricades, please contact us to arrange a pick up time.

    Contact Sharlene at 403-782-1261 or sbackman@lacombe.ca

    It is your responsibility to pick up and return the barricades back to Public Works at 5444 56 Avenue.

    
    

23. Do you want to borrow two A-Frame signs to advertise your block party? *

    1. Yes
    2. No
Leave This Blank:


27. 1. Receive an email copy of this form.
28. Email address

    This field is not part of the form submission.

29. Submit

* indicates a required field