Request for Family PIN

Reg-e & Tele-Reg Family Pin and Personal ID #'s

If you do not have a Family PIN #, are a new registrant, or need to update your family information, please submit this form and we will issue you a PIN # to use these e-asy registration systems or we will update your account information accordingly.
Request for PIN #'s will be accepted on an ongoing basis, but don't delay! Be ready to register now!
Lost or forgotten your PIN #? Reg-e's built-in email feature can instantly reply to your PIN SOS, but only if we have your correct email address in our database!

Personal information on this form is being collected pursuant to administrative procedures and will be used for the purpose of program administration, communication and registration only. Questions about this collection should be directed to the Promotions Coordinator, Town of Halton Hills, Recreation and Parks, 1 Halton Hills Drive, Halton Hills [Georgetown], ON L7G 5G2. (905) 873-2601 ext. 2268.

PIN Request:

Reason for PIN Request:

Main Contact:

Main Contact First Name:	*
Main Contact Last Name:	*
Gender:
Address:	*
Town:	*
Postal Code:	*
Province:
Tel. (Home):	*
Tel. (Business):
Tel. (Cell):
E-mail:	* *If you do not have an email address please download our PIN Request PDF form, fill it out and fax us the form.

Participant #1:

First Name:
Last Name:
Birthdate:
Gender:
Please identify any health conditions or special needs:

Participant #2:

First Name:
Last Name:
Birthdate:
Gender:
Please identify any health conditions or special needs:

Participant #3:

First Name:
Last Name:
Birthdate:
Gender:
Please identify any health conditions or special needs:

Participant #4:

First Name:
Last Name:
Birthdate:
Gender:
Please identify any health conditions or special needs: