Thank you for taking the time to fill out this form. This survey will be used as a tool to improve the services offered by Disabled Sports Eastern Sierra. Your comments are appreciated; thank you for your open and honest answers.

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* 1. Participant's name? (optional)

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* 2. Today's Date:

Date / Time

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* 4. Participant's gender

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* 5. Are you a veteran or current member of the U.S. Military?

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