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Injured Worker Picnic & Potluck Registration
Saturday August 16th - Withrow Park - Noon
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Name OR Organization
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Number of people coming with you
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Contact info (email preferred, or phone - so we can contact you if details change)
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If you are able to bring something for the potluck, what will you bring?
*We can reimburse up to $15 for what you bring if you provide receipts for ingredients you use or items you buy.
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If you are not able to bring something to the potluck, don't worry, we will provide some food. Do you have any dietary restrictions (is there anything you cannot eat)?
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