Pleasant Hill CERT 4th Annual Picnic Saturday, October 4, 2025
Please complete form below and submit
CERT Member Name
*
First Name
Last Name
Please provide total attending:
Email Address
*
example@example.com
Contact Number
*
Format: (000) 000-0000.
Please select your area
*
Please Select
Northeast Area
Northwest Area
Southeast Area
Southwest Area
Would you like to join the picnic committee
Yes
No
Submit Form
Should be Empty: