Water Smart® Event Request: Lifesaving Society Alberta and Northwest Territories

Request Form

Interested in having Lifesaving Society staff, Water Smart^®public education materials, or our Buddy the Lifeguard Dog mascot at your community event? Fill out this form and we will determine if and how we are able to support your event.

If you have any questions, please contact the Lifesaving Society at:

experts@lifesaving.org

780-415-1755

1. Name of Community Activation Event *

2. Purpose of Community Activation Event

3. Location of Event *

4. Date(s) of the Event *

5. Time(s) of the Event *

6. Primary Event Contact Information *

7. Estimated number of event participants

8. Estimated demographics of event participants

9. What are you requesting for the activation? *

Lifesaving Society Staff

Water Smart Materials

Buddy the Lifeguard Dog ($50 Plus GST and Shipping)

10. If you checked yes for Buddy the Lifeguard Dog, would you like to purchase the following?

Buddy Catchers ($8.95 per package of 100)

Buddy Tattoos ($25.00 per package of 125)

Buddy Stickers ($32.50 per roll of 100)

11. Do you have funding available to support the costs of sending staff, materials, etc? *

Yes

Unsure

12. Additional Comments:

Leave Blank

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