This information is being collected pursuant to the Health Protection and Promotion Act, R.S.O. 1990, c.H.7 and will be retained, used, disclosed and disposed of in accordance
with the Municipal Freedom of Information and Protection of Privacy Act, R.S.O. 1990, c.M.56, the Personal Health Information Protection Act, 2004, S.O.c.3 and all applicable
federal and provincial legislation and regulations governing the collection, retention, use disclosure and disposal of information. Any questions regarding this collection may be
directed to the Director of Corporate Services at 101 17th Street East Owen Sound, N4K 0A5, (519) 376-9420.