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BlueW Peterborough Registration
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* Indicates required question
Establishment Name
*
Your answer
Address with Postal Code
*
Your answer
Primary Contact Name(s)
*
Your answer
Email (for program use only, will not be posted)
*
Your answer
Phone Number
Your answer
Preferred method of communication
*
Email
Phone
Other:
Social Media Handles (Facebook, Instagram, Twitter, etc) this will be used for BlueW promotions
Your answer
Establishment Operating Hours
*
Your answer
Is your establishment seasonal?
Yes
No
Clear selection
If yes, what is your operating season(s)? Leave this blank if N/A.
Your answer
Where is your tap/how can it be accessed (ask staff, self serve etc)
Your answer
Any additional questions/concerns about the BlueW program or GreenUP?
Your answer
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