Operation Cherrybend Veteran Participant Application
Email address *
First Name *
Last Name *
Address (Street address, City, State, Zip)Complete *
Cell Phone # *
Branch of Service *
Years of Service *
What location were you stationed and/or military campaign? *
What year were you injured? What military campaign/location did the injury occur? *
Please select all that apply: *
Required
What is your Disability Rating? (Closest) *
Please list any other physical injuries not listed above. *
Do you use a wheelchair or track chair? *
Do you require transferring equipment or assistance for the accommodations or vehicles? *
Will you need to be booked off site for a hotel ADA room? *
Are you willing to push yourself to attend and participate in the activities of the event? *
This event is is a camp atmosphere with RV accommodations. You will be well fed, entertained with live music, and expected to engage and participate in activities with other veterans and crew. *
Can you drive yourself to the event? *
Will you need to fly in to the event? *
Do you have a sponsor that would pay for your travel to the event if you are located outside of Ohio? *
Can you commit to this years event? We need a solid commitment for your participation. *
Why do you want to attend this particular event? *
What activities do you like the BEST? *
Required
What activities do you like the LEAST? *
Required
Is there anything else you would like us to know about you? *
Can you please list a person as a reference that we may contact? ( Not a family member.) *
Please list an Emergency Contact to keep on file. (Name and Cell number) *
Please list your Spouse or Partner. (Name and Cell #) *
What size T-shirt do you wear? *
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy