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Registration Form

Special Education: What You Need to Know, Dream Big Dreams for Your Child August 23 (Roseburg)
08/23/2018 05:00 PM - 09:00 PM PT


  • Free  -  Family Member
  • $25.00  -  Professional or Need Certificate of Attendence

English: If you have questions or need help filling out the registration form, please send an e-mail or call us at 503-786-6084 or email 

Español: Google Translate (el enlace aparece en la esquina superior derecha) ayudará con la traducción de esta página de inscripción. Si tiene preguntas o necesita ayuda para llenar el formulario de inscripción, sírvase enviar un mensaje por correo electrónico a o llámenos al 1-888-988-3228. Por favor asegúrese de informarnos si necesita interpretación al completar el formulario de inscripción.

Русский: Интернет-переводчик «Google Translate» (ссылка выше справа) поможет вам перевести данную страницу с информацией о регистрации. Если у вас есть вопросы или вам нужна помощь в заполнении регистрационной формы, пожалуйста, пишите на эл. ящик или звоните по телефону 1-888-988-3228. Пожалуйста, не забудьте указать в форме для регистрации, что вам нужен переводчик.

tiếng Việt: Google Translate (kết nối phía bên phải trên đây) sẽ giúp phiên dịch trang ghi danh này. Nếu quý vị có thắc mắc hoặc cần trợ giúp điền đơn ghi danh, xin gửi email về hoặc gọi điện thoại cho chúng tôi tại số 1-888-988-3228. Xin khẳng định thông báo cho chúng tôi biết quý vị cần thông dịch khi điền mẫu ghi danh này.
Demographic Information:
While the demographic information you provide is voluntary, the funding agencies that support FACT Oregon's work request demographic data periodically to make sure we are meeting our diverse community's needs. This information is anonymous, and will not affect support or services you receive from FACT Oregon.
FACT Oregon encourages you to set up your own account! You can update your information, make registering for an event a snap, or view donations!
Please create a login name and password, or use Facebook or Google to sign in! It's easy!
(Your password must be at least eight characters long, and contain at least one number.)
Waiver Statement:

Media Release Waiver

I hereby consent that the photographs and/or videos in which I and/or my child(ren) appear may be used by Family and Community Together (FACT Oregon), its assigns or successors, in any publication, multimedia production, display, advertisement or World-Wide Web Publication. Furthermore, I hereby consent that such information, photographs and videos shall be their property, and they shall have the right to sell, duplicate, reproduce and make other uses of such information, photographs and videos as they may desire free and clear of any claim whatsoever on my part. I release and forever discharge Family and Community Together (FACT Oregon), its agents, officers and staff from any and all claims and demands arising out of or in connection with the use of said photographs/images, including but not limited to, any claims for invasion of privacy or defamation.

If you have any questions or concerns, please call (503) 786-6082 or email: to register.

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