Advanced Recreation Therapy Registration Form
Come join us on Saturday, November 15th from 4-8pm at The Guild Brewing Co, 99 Water Street Warren, RI!
All are welcome for an evening of community, good food and drink, and optional painting! Valid ID needed for alcoholic beverages, non-alcoholic options available. Small bites will be provided with additional food available at own cost. All participants are responsible for purchasing individual beverages. Additional brewery information can be found at: https://www.theguildwarren.com
Please select with event/date you are registering for:
*
Community Brew & Paint Night @ The Guild in Warren, RI on November 15, 2025
Back
Next
Participant Information:
Name
*
First Name
Last Name
DOB
*
-
Month
-
Day
Year
Date
What gender do you identify as?(Collected for grant purposes only)
*
Female
Male
Nonbinary
Transgender
Prefer Not to Say
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
Please enter a valid phone number.
Email
*
example@example.com
Level of injury
*
Back
Next
Emergency Contact Information
In case of emergency, who should we contact?
Name
*
First Name
Last Name
Phone Number
*
Please enter a valid phone number.
Relationship to Participant
*
Back
Next
Will you be attending alone or need a +1? (Please be considerate as this determines food order and room capacity for the event, thank you!)
*
Just me!
I'll bring someone!
Would you like to paint? (This helps us determine number of materials needed)
*
Yes
No, I'll just come for the friends and food!
Back
Next
I understand that by participating in this JTF experience, I am responsible for all transportation to the Guild Brewing Co.
*
I understand
I understand that all ages are welcome, but valid ID must be presented for the purchase and consumption of alcohol in compliance with state law.
*
I understand
I understand that small bites will be provided, but I am responsible for the purchase of all additional food and any beverages, alcoholic or non-alcoholic.
*
I understand
Back
Next
How did you hear about this event?
*
Submit
Should be Empty: