Please complete the information on the form. Please ensure you sign the waiver form. A waiver is required before participating in recreation programs.
STOP. This waiver is an important legal document. Read it carefully. Signing this waiver is a condition of participating in the recreation program you have signed up for (the “Activity”), which is being offered by the City of Belleville (the “City”).
I, the undersigned, understand, covenant, and agree with the City as follows:
By signing my name below, I declare to the City that: (1) I am assuming all the risks associated with my or my child participating in the Activity; (2) I am giving up my right and my child’s right to sue the City for any and all damages that may arise out of my or my child participating in the Activity; (3) I am my child’s parent or legal guardian (if applicable).
Notice of Collection
All information including Personal Information, collected by the CIty of Belleville is done so under the authority of the Municipal Act, 2001 and the Municipal Freedom of Information and Protection of Privacy Act, each as amended and will be used for the administration purposes of the City of Belleville's recreation programs and facilities and wellness passport program. Questions about the collection of this personal information should be directed to: City Clerk, 169 Front Street, Belleville ON K8N 2Y8, Telephone: 613-968-6481.
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