Leisure Assistant Pass Application

 

The Leisure Assistant Pass is for people with disabilities, of all ages, who require the assistance of a support person when engaging in leisure activities. Upon presentation of the pass at a participating venue, one support person will be given free or reduced admission; facilitating participation, while ensuring the person with a disability does not pay double for their admission. Passes are valid for a 1 year term from the date of issue. As support persons may change, the pass will be issued to the person with a disability. 

By submitting this form, I represent a person with disability and agree to the terms of use, including:
Recognizing an individual may be independent in one environment and not in another, Leisure Assistant Pass holders are expected to only use their passes at venues where assistance is required. Within each venue, persons with a disability and assistants are expected to stay together. Misuse or abuse of the pass could result in termination of it and its privileges. I understand there is a $10 replacement fee for a lost or misplaced pass. 

 
1 Start 2 Complete
Note: As support persons may change, the pass will be issued to the person with a disability, referred to as "client".