Participant Form
Register yourself and choose your preferred timeslot. Each slot only allows ten participants. Payment required to finalized reservation. Make checks payable to Roseburg Sister Cities, Inc. Send to P.O. Box 1643 Roseburg, OR 97470
Full Name
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First Name
Last Name
Email Address
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example@example.com
Select Your Time Slot
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I acknowledge that food is prepared in a shared kitchen and cannot be guaranteed to be free of common allergens.
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Yes, I understand and will take proper precautions.
I understand that while RSC aims to accommodate dietary preferences, vegan and vegetarian options may be limited.
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Yes, I understand.
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Are you currently a Roseburg Sister Cities, Inc. Member?
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Yes!
No, but I am interested in joining.
No, I am not ready to join RSC yet.
By selecting 'yes' below you agree to pay the $50 ticket price and understand that reservation is finalized only when payment is received. Payments can be made to Roseburg Sister Cities, Inc. - P.O. Box 1643 Roseburg, OR 97470.
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Yes, I understand and I have mailed in payment.
Register
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