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Registration Form for the Westerpark Neighborhood Safari

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Registration

Please note that fields marked * are required

Use this form to sign up for the Neighborhood Safari through Westerpark on Wednesday, July 1, from 1:00 p.m. to 3:00 p.m.

Please note! Please fill out a separate form for each visitor.

First names *

Insert(s)

Last name *

Phone number

Sometimes we need additional information. We may call you if you enter your phone number.

Email address *

We will notify you via email when we receive this form.

What age group do you fall into? *

0–12

13–18

18–25

25–65

65+

Which neighborhood do you live in? *

Buytenwegh

Downtown

The Leyens

Dorp

Driemanspolder

Meerzicht

Noordhove

Oosterheem

Rokkeveen

Seghwaert

Otherwise, namely

Which neighborhood do you live in?

Do you have any questions or suggestions?