Entertainment Request Application (Child Life)

Thank you for your interest in providing entertainment for the patients at The IWK Health Centre. Please review the Guidelines for Entertainers carefully before submitting this application.

Due to staff availability, there are only certain times we can accommodate special visitors. Please know that there are a limited number of open slots each month. Slots are filled on a first come, first served basis.

All applications will be reviewed for appropriateness of activity, size and ages of the visiting group and scheduling availability. Completion of an application does not guarantee acceptance or scheduling of a visit, however we will do everything possible to accommodate your request. Thank you.

Please submit details about your proposed entertainment at the IWK Health Centre. Fields marked with an aterisk (*) are mandatory.

Please note, due to staffing and volunteer resources, please contact our Special Events Coordinator at 902.470.8426 for the times when we can accomodate your special event.

First Name: *

Last Name: *

Name of group/performance: *

Email address: *

Confirm email address: *

Phone number (e.g. 215-590-0000): *

Best time to call:

Fax number (e.g. 215-590-0000):

Type and content of event. Please provide as much detail as possible.: *

Number of people in group. (all individuals must be 16 or older): *

Space and/or equipment needed: *

Proposed performance date: *

Proposed performance time: *

Alternate performance date:

Alternate performance time:

Is there a charge for the performance? If so what is the total cost?: *

Is media coverage being sought?:

If yes, a copy of any press releases/advisories must be submitted to the IWK Public Relations Department at least one week prior to your visit. Please call 902.470.6740

As representative of the above name organization. I have read the IWK's Guidelines for Entertainers visiting the IWK Health Centre.: *

I agree to adhere to these requirements

I have not read or do not agree to adhere to these requirements

Leave this field blank:

1.902.470.8888

1.888.470.5888

Emergency: 911

Telecare: 811

Poison: 1-800-565-8161

5850/5980 University Ave., Halifax, NS B3K 6R8

Entertainment Request Application (Child Life)

Contact Directory

IWK Foundation