2. Contact Details:
4. First/Last Name:*
5. Email Address:*
6. Telephone Number:*
8. Event Details:
10. Name of Event:*
11. Event Location:*
13. Number of Totes Required:
15. Recycling*
    -- Select One --01234
16. Refundables*
    -- Select One --01234
17. Organics*
    -- Select One --01234
18. Garbage*
    -- Select One --01234
20. Hauling Options:
22. Self Haul

    Everyday between 9:30AM - 3:30PM (excluding holidays)

23. Pick-up Date:
24. Drop-off Date:
26. CVRD Haul

    CVRD Haul * CVRD Staff tote delivery and pick-up times may vary between 9:30AM - 3:30PM Monday - Friday

    * See below for list of charges.

27. Drop-off Date:
28. Pick-up Date:
30. Fees:

    Visit the CVRD office at 175 Ingram Street in Duncan to provide the mandatory $200 deposit (pay by cash, cheque or credit card). This deposit will be used to cover fees associated with garbage ($164/tonne) and organics ($125/tonne) disposal. It may also be used to cover processing contaminated materials, and unclean or damaged totes.

32. 

34. * The tote deposit will be returned by mail in the form of a CVRD cheque within four weeks following your event given totes are clean and undamaged.

36. Return Deposit to:
38. First/Last Name:
39. Telephone Number:
41. Address:
43. I acknowledge that I have read and understand event details and instructions for this program.*

    1. Yes
    2. No
Leave This Blank:


45. 1. Receive an email copy of this form.
46. Email address

    This field is not part of the form submission.

47. Submit

* indicates a required field