Deaf+Autism Family Day RSVP
This event is designed for children who have a dual diagnosis of deaf/hard-of-hearing AND an Autism Spectrum Disorder (ASD), and their families. Families who navigate hearing differences and neurodivergence (i.e. ASD) have unique needs and are often underresourced--this day is for you!
Please fill out this form to register as a family or as a volunteer for the Deaf+Autism Family Day at Happy Dog Ranch on September 29, 2018 from 9:30am-1:00pm.
In case of inclement weather and/or cancellation, updates will be posted on the CO Hands & Voices Facebook page, the Natural Wisdom Counseling Facebook page, and www.naturalwisdomcounseling.com. Please save this information.
Sign in to Google to save your progress. Learn more
What is your full name? *
What is your phone number? *
What is your email address? *
What is your preferred method of contact? *
Have you attended the Deaf+Autism events in the past? *
Of your family members, what are the names of the ADULTS attending the Deaf+Autism Family Day event?
Of your family members, what are the names (and ages) of the CHILDREN attending the Deaf+Autism Family Day event?
What is your school district? *
What do you/your family hope to get out of this event. *
Do you (or one of your family members attending) need any special accommodations? If so, please describe (i.e. oral communication, ASL, behavior support, wheelchair access, etc.). Due to the nature of activities, CART services will not be available. *
Do you (or one of your family members attending) have any special dietary restrictions? If so, please describe. (i.e. vegetarian, GF, Dairy Free, allergies, etc.) *
If you are a volunteer, what things do you want to support?
Please write any additional information that you feel is important to share before this event.
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy
Google Forms