1. PARTICIPANT INFORMATION Participant Name (required) Date of Birth (required) Gender (required) Mobility or Medical Concerns (required) What types of sports and/or crafts would you like to try? (soccer, basketball, bracelets, painting, etc.) 2. EMERGENCY CONTACT INFORMATION Parent or Caregiver (required) Contact Number (required) Secondary Contact Number Your Email (required) Note: The email address given above will be used to inform you of important program information only and will not be used for marketing purposes nor will it be shared with a third party. Mailing Address 3. TIME AVAILABILITY Select an available time that works for you: 10:30-11:30 AM11:30 AM-12:30 PM 4. CONSENT PLEASE READ the Consent form located here before submitting your registration form. I HEREBY ACKNOWLEDGE THAT I HAVE READ AND UNDERSTAND THIS DOCUMENT.
