Signup Form for Recreational Activities in February 2021
Dear Veteran, thank you for signing up! You will receive a confirmation later with more details on the meeting point. Currently, we consider Douglas County Library parking lot or Eagle Landing. These activities are subject to change due to weather conditions or any other unpredictable situations. We look forward to seeing you!
If you have any questions about our activities in February 2021, please contact us at 541.580.5655 or
elena@sourceoneserenity.org
.
* Required
In February 2021, we offer two outings. Please check one or both you would like to attend.
*
February 13, Saturday: Meeting at 11 am (meeting point will be disclosed in the confirmation). Outing to Whistler's Bend Park for a walk and a casting class in fly fishing. Leaving Whistler's Bend Park at 3 pm). We also provide a light lunch.
February 20, Saturday: Meeting at 10 am (meeting point will be disclosed in the confirmation). Outing to North Bank Habitat for a hike with a guide. Please be prepared for a rain. Coming back to Roseburg at about 3 pm. We also provide a light lunch.
Required
Your First and Last Name
*
Your answer
How can we contact you by phone and/or email address? Please leave your contact information.
*
Your answer
Do you want to bring your family? Please indicate how many family members you will come with.
Your answer
We would like to learn more about you and consider it in our future activities. Where do you live?
*
I live at Eagle Landing
I live at Orchard Knolls Apartment
I live in Roseburg or in proximity of 20 miles from Roseburg
Other:
Required
We provide transportation by renting a van. Do you want to use our transportation? it is at no cost to you.
*
Yes
No
If you want to use transportation, what meeting point you would prefer? Please check all boxes that apply to you.
*
Douglas County Library parking lot (address: 1409 NE Diamond Lake Blvd, Roseburg)
Chadwick Clubhouse (1157 SE Douglas Ave, Roseburg across the Courthouse)
Eagle Landing (990 NW Veterans Way, Roseburg on the VA's campus)
Other:
Required
Submit
Never submit passwords through Google Forms.
This form was created inside of Umpqua Nexus.
Forms