Positive Opportunity Partnership For Kids

The Positive Opportunity Partnership (POP) subsidy assists families with children who would otherwise be unable to participate in recreational programs.

We do not disclose personal information submitted through this form to any outside parties. Please see our site privacy policy for more information.

Applicant Information

E.g. Gananoque Minor Hockey

Proof of income is required for application approval. To learn how to get a proof of income statement, see the CRA website.

Reference

Please provide a reference that is familiar with your situation and who can verify that you require assistance from the P.O.P. program. This person cannot be a family member or friend.

By my signature and submission of this form I authorize the reference provided to release personal information as required for program placement in the The Town of Gananoque P.O.P. program. I further authorize P.O.P. to collect this information.

Before submitting this application and participating in the activity described in this application (the “Activity”), I agree, or as the parent or guardian of a person under the age of 19 I agree, as follows:

  1. I understand that participating in the activity could result in severe or fatal injury to me (or my child) or others. I freely accept and fully assume this risk; and I acknowledge my responsibility to discuss my participation in the activity with my doctor (or my child’s doctor);
  2. I consent to receive (or that my child receive) medical treatment which may be deemed advisable in the event of injury, accident and/or illness during this activity or event.
  3. I hereby waive any and all claims arising from my participation in the Activity that I have (or my child) or may have in the future against the Town, its elected officials, officers, employees, games officials, volunteers and representatives associated with my (or my child’s) participation in the Activity (hereinafter collectively referred to as the "Releasees");
  4. I agree to release the Releasees from any and all liability for death or any loss, damage, injury or expense that I may suffer, or that my next of kin may suffer arising from my (or my child’s) participation in the Activity or due to any cause whatsoever;
  5. I agree to indemnify the Releasees from any and all liability for any damage to property of or personal injury to, any third party, arising from my participation in the Activity;
  6. I agree that this agreement is binding upon my heirs, next of kin, executors, administrators, assigns and representatives in the event of my death or incapacity; and,
  7. The information provided in this form is accurate.

By inserting my name below, the date, and clicking “submit” I declare that I understand the risks associated with the activity and that I am giving up my right or my child’s right to sue the Town for damages if I am or my child is injured while participating in the activity, and declare that I am 19 years of age or older or that I am the parent or legal guardian of the applicant and that the application is being made with my approval.