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Peel Regional Police - Peel Children's Safety Village

Bike Rodeo Kit Request Form

Event Information

Name of Organization

Name of Event

Location (Facility name and address)

Date of Event

Start time of Event

End time of Event

Expected # of Participants

Description of Event

Applicant Information

Last Name

First Name

Location: Street Address

City

Postal Code

Primary Phone Number (999-999-9999)

Phone extension (e.g. 9999)

Alternate Phone Number (999-999-9999)

Phone extension (e.g. 9999)

Email Address

Office Use Only

Picked Up Date: _________________________

Picked Up By: _________________________

Returned Date: _________________________

Returned By: _________________________

If you have any questions regarding the kit, please contact safetyvillage@peelpolice.ca or call 905-453-3311 ext. 4071

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