City of London - Request for Waiving or Reducing of Fees for Use of City-owned Community Centres and Recreation Facilities

Note: Fields marked with ★ are mandatory.

Section 1 - Applicant Information

Name of Group or Organization:

Event Title:

Brief description of event:

Contact Name (must have signing authority):

Primary Phone #:

Secondary Phone #:

E-mail address:

Applicants role within the organization:

Address of the organization:

Section 2 - Request Details

What date would you like to book the facility?

Start Time of Potential Rental

End Time of Potential Rental

If you would like to book more than one date, please list other dates here - yyyy/mm/dd (please separate dates with a comma)

Please provide an estimated number of participants that you expect will attend per visit.

Are there any special requirements of the space you are requesting? If yes, please explain (i.e. kitchen, projector screen, etc.) If not applicable, indicate NA

Do you require a specific kind of space for the purposes of your activity? If yes, please explain (i.e. meeting room, gymnasium, ice rink, etc.) If not applicable, indicate NA.

Please select your top two choices from the list of facilities below. If you're unsure of which facility you would like to choose, please feel free to research the available options by vising our Community Centres Page

Swimming Pools:Canada Games Aquatic Centre (CGAC)
Carling Heights Optimist Community Centre (CHOCC)
East Lions Community Centre (ELCC)
South London Community Pool (SLCP)
Outdoor Pool or Wading Pool (please provide location, if known, in the 'other' box below)

Will music be played at your event?Yes
No

Will there be dancing at your event?Yes
No

Will you be providing your own insurance?Yes
No

Section 3 - Information About Your Organization

Are you a not-for-profit organization?Yes
No

Is your organization formally incorporated?Yes
No

If yes, what is your incorporated name and number?

Can you verify that your activity is not for the purposes of fundraising, commercial activity or charging admissions?Yes
No

Are you a London based program (i.e. a minimum of 80% of your participants reside in London)?Yes
No

If NO, please comment:

Do you charge a membership/participation/registration fee?Yes
No

If YES, please explain:

If OTHER, please specify:

Briefly describe (less than 250 words) how your group aligns with Council Strategic Priorities, examples of which include: a) supporting neighbourhood driven activities and decision making; b) supporting immigrants and newcomers to be successful as they settle in our community; c) support all Londoners to feel engaged and be involved in our community; d) support all Londoners to age well and have opportunities to reach their full potentional; e) support the health and well-being of all children, youth and families in London.

Briefly describe how someone becomes a member of your group:

Briefly describe why the City of London rental fees present a barrier for your group:

Section 4 - Recurring Requests

Are you currently renting City of London space or using the Sport Allocation program?Yes
No

Have you been granted a Waiving or Reducing fee application in the past?Yes
No

Has your group improved its ability to afford City of London rental fees since your last request?Yes
No

Please explain:

Submitter E-mail (In case we need to reach you regarding this submission)

Thank you for your inquiry. Upon receipt of your submitted form, a member of the Recreation and Sport Team will be in contact within ten business days. Any general inquiries about this application can be emailed to recreation@london.ca.

The personal information collected on this application form is collected under the authority of the Municipal Act, 2001, as amended, and will be used to respond to questions or comments submitted to the City of London from members of the public using www.london.ca, 'Request for Waiving or Reducing of Fees for use of City-owned Community Centres and Recreation Facilities' form. Questions about this collection of personal information should be addressed to Supervisor, Customer Service, Parks and Recreation, City of London, 355 Wellington Street, Suite 248, PO Box 5045, London, ON N6A 3N7. Tel: 519-661-CITY (2489) ext. 5579.

Note: If the form does not appear to submit, please open each section and confirm that there are no issues or missing required fields.