Kennebec Highlands Summerer Hiking Club
Exit this survey
1. Default Section
*
1
. Please input your name, date of birth, email address, and phone number
Please input your name, date of birth, email address, and phone number
Name
DOB
Email address
Home Phone
Cell Phone
*
2
. Which group are you interested in joining, the Recreation Hiker's Group or the Healthy Start Hiker's Group?
Which group are you interested in joining, the Recreation Hiker's Group or the Healthy Start Hiker's Group?
3
. What part of the program do you find most appealing, in other words what draws you to the program?
What part of the program do you find most appealing, in other words what draws you to the program?
4
. What weekday works best for you?
What weekday works best for you?
Monday
Tuesday
Wednesday
Thursday
5
. What time of day works best for you?
What time of day works best for you?
9:00
10:00
11:00
12:00
1:00
2:00
3:00
4:00
5:00
6:00
7:00
any
6
. Do you have any concerns that you would like to share before the program begins?
Do you have any concerns that you would like to share before the program begins?
7
. Any additional comments?
Any additional comments?
Thank you for signing up as a potential participant! Sometime in April or May we will follow up with an email or phone call with more details on the club. If you have any questions you can email or call Sarah Zazzaro at brcacc@gwi.net or 495-6039.
Powered by
SurveyMonkey
Create your own
free online survey
now!
Javascript is required for this site to function, please enable.