Senior Center Activity Registration

Senior Center Activity Registration — Form Fields

This registration template includes 9 fields. Register seniors for classes, activities, and events at a community senior center. Free to customize and use on ZenBuild.

• Participant Name (text, required)
• Email Address (email, optional)
• Phone Number (text, required)
• Activity you are registering for (dropdown selection, required) — options: Yoga/Stretching, Water aerobics, Painting class, Line dancing, Bridge club, Computer skills, Book discussion, Cooking demo, Tai chi, Gardening
• Emergency contact name (text, required)
• Emergency contact phone (text, required)
• Do you need transportation assistance? (multiple choice, required) — options: Yes, No
• Do you have mobility limitations we should know about? (multiple choice, required) — options: Yes, No
• Accessibility needs or health notes (long text, optional)