Food Is Medicine Event Registration Form

Know Your Rights Training and Community Dinner: Friday, February 14th 2025, 5 pm - 7:30 pm; Reach Dane 2096 Red Arrow Trail, Fitchburg 53711
Registration is so that we can adequately plan for this event.

If you do not want to provide your personal information, then just skip to the section to let us know how many adults will be attending.

If you require childcare, we do require the names and ages of your children.

Thank you.
Family / Primary Individual Name
Name

First NameLast Name
Email
example@example.com
Phone Number
Format: (000) 000-0000.
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
TelephoneTextEmail
Community memberProvider
1234
Please let us know if you need childcare
Children needing childcare
Any Questions?
Should be Empty:

Know Your Rights Training and Community Dinner: Friday, February 14th 2025, 5 pm - 7:30 pm; Reach Dane 2096 Red Arrow Trail, Fitchburg 53711