Temporary Access Pass — Application

RDOS Emergency Operations Centre · fills the official PDF form on your phone, then shares it to your email app. This is an application to be registered for consideration of a pass — it is not a pass.

Applicant

Date Full legal name *

Age

Phone 1 *

Phone 2 (optional) Email * — your pass is emailed back to this address Home address Status in relation to Order location (e.g. primary residence, farm in Order area, utility, private contractor)

Farm / company / agency

Farm, company or agency name Premises ID (if applicable) Address of location in Order area (if different from home address) Type

Commercial farm Hobby farm N/A

Type of farm / business / agency Length of time required in Order area

Vehicle

Make / model

Colour

Plate number

Others in vehicle (name, age and phone #)

Purpose of access

Reason for entry and destination * Route to destination Mitigation / preparedness measures taken Comments (optional)

Waiver — name & address

Pages 3–4 of the form are a release of liability — by signing you waive certain legal rights, including the right to sue. You will be able to review the full completed document, including the waiver, before anything is sent. Nothing is submitted — and you are not committing to anything — until you email the PDF yourself.

Last name

First name

Initial

Province

Street

City

Postal code

Signature

Type your full name — it becomes your signature on the applicant declaration (page 1) and the waiver (page 4).

Type your full name to sign *

By typing your name you are signing this application and the waiver. You can still review the whole document before anything is sent.

A witness must still sign the witness line — the EOC can do this when you present ID, or a witness can sign a printed copy.

PDF created

YOU ARE NOT DONE YET!
Your application has NOT been sent. Finish the steps below to email the PDF to the EOC.

Review the completed PDF first (application + waiver)

Read it over — you commit to nothing until you send the email.

Sends the completed PDF directly from this page — no email app needed.

— or email it yourself —