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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, please contact us to arrange a pick up time.
    Contact the City of Lacombe
20. Will you be requiring barricades to partially close down a lane?*

    1. Yes
    2. No
21. If yes, please contact us to arrange a pick up time.
    Contact the City of Lacombe

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


23. 1. Receive an email copy of this form.
24. Email address

    This field is not part of the form submission.

25. Submit

* indicates a required field