Registration Participant Information ——————————————————————— First Name(required) Last Name(required) Title Contact Email(required) Contact Phone Address (only for new participants) Town Zip Medical Conditions we need to know, swallowing difficulties, incontinence…(required) Day(s):(required) Tue & Th Tuesday only Thursday only Another Walking:(required) No Assistance Walker Cane Other Diet:(required) None Vegetarian Diabetic Other Vaccines:(required) COVID19 x 2 Current Flu Other * Member of Oasis? Yes No Agree to Terms & Conditions(required) Yes No Other request(s), special needs etc… Send —————————————————————————————————— Membership entitles registrant to some additional benefits. Please keep in mind that this is a non-medical facility. If your love one needs care, assistance needs to be provided. Terms and Conditions Δ Like this:Like Loading...
