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.
In February 2021, we offer two outings. Please check one or both you would like to attend. *
Required
Your First and Last Name *
How can we contact you by phone and/or email address? Please leave your contact information. *
Do you want to bring your family? Please indicate how many family members you will come with.
We would like to learn more about you and consider it in our future activities. Where do you live? *
Required
We provide transportation by renting a van. Do you want to use our transportation? it is at no cost to you. *
If you want to use transportation, what meeting point you would prefer? Please check all boxes that apply to you. *
Required
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This form was created inside of Umpqua Nexus.