Participant #1
*
Last Name
First Name
Participant #1 Email Address
*
example@example.com
Participant #1 Phone Number
*
Please enter a valid phone number.
Participant #2 (if applicable)
Last Name
First Name
Participant #2 Email Address
example@example.com
Participant #2 Phone Number
Please enter a valid phone number.
Vegetarian plate? (This consists of us serving the planned menu without beef, chicken, or fish on the plate.) Click all that apply.
No thanks! I (we) eat meat!
1 participant — 100% Vegetarian
2 participants — 100% Vegetarian
I (we) eat fish but no chicken or beef.
1 Veggie/1 Meat-eater
OCTOBER — Check off the applicable boxes next to any date(s) you would like to register for and then hit "submit". You DO NOT have to do this for every date listed.
*
EXERCISE
PROGRAM
LUNCH
NOT ATTENDING
TUESDAY, OCT 1
TUESDAY, OCT 8
THURSDAY, OCT 10
TUESDAY, OCT 15
TUESDAY, OCT 22
TUESDAY, OCT 29
THURSDAY, OCT 31
NOVEMBER — Check Appropriate Boxes
EXERCISE
PROGRAM
LUNCH
NOT ATTENDING
TUESDAY, NOV 5
THURSDAY, NOV 7
TUESDAY, NOV 12
THURSDAY, NOV 14
TUESDAY, NOV 19
THURSDAY, NOV 21
TUESDAY, NOV 26
DECEMBER — Check Appropriate Boxes
EXERCISE
PROGRAM
LUNCH
NOT ATTENDING
TUESDAY, DEC 3
THURSDAY, DEC 5
TUESDAY, DEC 10
THURSDAY, DEC 12
TUESDAY, DEC 17
THURSDAY, DEC 19
JANUARY — Check Appropriate Boxes
*
EXERCISE
PROGRAM
LUNCH
NOT ATTENDING
THURSDAY, JAN 2
TUESDAY, JAN 7
THURSDAY, JAN 9
TUESDAY, JAN 14
THURSDAY, JAN 16
TUESDAY, JAN 21
THURSDAY, JAN 23
TUESDAY, JAN 28
THURSDAY, JAN 30
FEBRUARY — Check Appropriate Boxes
*
EXERCISE
PROGRAM
LUNCH
NOT ATTENDING
TUESDAY, FEB 4
THURSDAY, FEB 6
TUESDAY, FEB 11
THURSDAY, FEB 13
TUESDAY, FEB 18
THURSDAY, FEB 20
TUESDAY, FEB 25
THURSDAY, FEB 27
Do you plan to attend the Purim Ball on Tuesday, March 26?
I'M COMING!
BUMMER. CAN'T MAKE IT
PURIM BALL ON TUES, MARCH 11
MARCH — Check Appropriate Boxes
*
EXERCISE
PROGRAM
LUNCH
NOT ATTENDING
TUESDAY, MAR 4
THURSDAY, MAR 6
TUESDAY, MAR 11
THURSDAY, MAR 13
TUESDAY, MAR 18
THURSDAY, MAR 20
TUESDAY, MAR 25
THURSDAY, MAR 27
APRIL — Check Appropriate Boxes
*
EXERCISE
PROGRAM
LUNCH
NOT ATTENDING
TUESDAY, APR 1
THURSDAY, APR 3
TUESDAY, APR 8
THURSDAY, APR 10
TUESDAY, APR 22
THURSDAY, APR 24
TUESDAY, APR 29
MAY — Check Appropriate Boxes
*
EXERCISE
PROGRAM
LUNCH
NOT ATTENDING
THURSDAY, MAY 1
TUESDAY, MAY 6
THURSDAY, MAY 8
TUESDAY, MAY 13
THURSDAY, MAY 15
TUESDAY, MAY 20
THURSDAY, MAY 22
TUESDAY, MAY 27
THURSDAY, MAY 29
JUNE — Check Appropriate Boxes
*
EXERCISE
PROGRAM
LUNCH
NOT ATTENDING
THURSDAY, JUN 5
TUESDAY, JUN 10
THURSDAY, JUN 12
TUESDAY, JUN 17
THURSDAY, JUN 19
TUESDAY, JUN 24
THURSDAY, JUN 26
JULY — Check Appropriate Boxes
*
EXERCISE
PROGRAM
LUNCH
NOT ATTENDING
TUESDAY, JUL 1
THURSDAY, JUL 3
TUESDAY, JUL 8
THURSDAY, JUL 10
TUESDAY, JUL 15
THURSDAY, JUL 17
TUESDAY, JUL 22
THURSDAY, JUL 24
TUESDAY, JUL 29
THURSDAY, JUL 31
AUGUST — Check Appropriate Boxes
EXERCISE
PROGRAM
LUNCH
NOT ATTENDING
TUESDAY, AUG 5
THURSDAY, AUG 7
TUESDAY, AUG 12
THURSDAY, AUG 14
TUESDAY, AUG 19
THURSDAY, AUG 21
SEPTEMBER — Check Appropriate Boxes
EXERCISE
PROGRAM
LUNCH
NOT ATTENDING
TUESDAY, SEP 2
THURSDAY, SEP 4
TUESDAY, SEP 9
THURSDAY, SEP 11
TUESDAY, SEP 16
THURSDAY, SEP 18
THURSDAY, SEP 25
TUESDAY, SEP 30
BERGEN COUNTY ANNUAL SENIOR FESTIVAL at VAN SAUN PARK – Please check ALL that apply.
YES! I will attend on Thursday, September 12
YES! Please include me for a KOSHER BOX LUNCH on September 12
NO, I WILL NOT be able to attend the Seniors Festival on SEPTEMBER 12
YES! If postponed, I will attend on the rain date, Tuesday, September 17
YES! Please include me for a KOSHER BOX LUNCH on the rain date, September 17
NO, I WILL NOT be able to attend the Seniors Festival on SEPTEMBER 17
Submit
Should be Empty: