The completed form must be submitted to Renfrew County and District Health Unit ten (10) business days before the event. Call us at 613-732-3629 extension 505 if you have any questions.

If seeking exempt status, ensure the form is filled out by a member of the exempt organization (service club, fraternal organization, religious group) making the application.

The food concession is prohibited from operating until approval is granted.

The personal information on this form is collected under the authority of the Health Protection and Promotion Act and will be used for the administration of Public Health programs. Any questions about the collection of this information should be directed to the Manager of Environmental Health, Renfrew County and District Health Unit, 141 Lake St. Pembroke Ontario K8A 5L8, 613-732-3629 extension 505.