2020 Summer Program Registration Survey for Adult Therapeutic Recreation Participants

In an effort to make the registration process accessible to everyone, BPRD-TR is using this survey to increase the likelihood that many of you will be selected to enroll in several of your top choices for fall programs. The survey will be open from March 30th- May 1st. You will be notified by May 15th of your classes and arrangements for payment must be received by May 22nd or your spot will be forfeited. If at anytime you have questions, please don't hesitate to contact Cheryl Kelley at 541-706-6121 or cheryl@bendparksandrec.org. 

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* 1. What is the participant's name?

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* 2. Today's Date?

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* 3. Please enter parent or caregiver contact information.

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* 4. Do you require transportation from the Norton apartments to programs that are located at an offsite location?

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* 5. Do you use a wheelchair or other mobility device?

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* 6. Please rank the following fitness programs in order of your preference. If you are NOT interested in the class select N/A.

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* 7. Please rank the following art/craft classes in order of your preference. If you are NOT interested in the trip select N/A.

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* 8. Please rank the following cooking classes in order of your preference. If you are not interested in the trip select N/A.

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* 9. Please rank the specialty programs in order of your preference. If you are NOT interested in the program select N/A.

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* 10. Please rank the day trips in order of your preference. If you are NOT interested in the trip select N/A.

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* 11. Please rank the overnight trips in order of your preference. If you are NOT interested in the trip select N/A.

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* 12. Would you like to register for the End Of Summer Cookout?  (3 hours)
Date: 8/24, Time: 4pm-6:30p, Day: Sunday, Location: Aspen Hall, Cost: $25 per family; Families are invited to attend.

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* 13. In order to speed registration process, how much (either with or without scholarship depending on qualification) are you willing to spend on fall programs? Your answers will not affect your choices, only how many classes you will be originally registered. Once I reach the maximum amount, I will not register the participant for anymore classes.

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* 14. Are you planning on using K-Plan, Full Access, or other sources of funding for payment? If so, please explain.

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* 15. How would you like to be contacted about program details each week if needed?

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