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Sensory Calming Space Request
Thank you for your interest in a My Autism Ally Sensory Calming Space.  We enjoy creating spaces where neurodiverse individuals and their families can calm and regroup so that they can continue to enjoy large community events and/or activities throughout northeast Indiana.  
 
Your response DOES NOT GUARANTEE AVAILABILITY or reserve your dates.  We will contact you to discuss your event needs, send pricing information and verify dates requested. 
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Contact Person Email
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Date of Event
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Location of event/address with city
Tell us about the event.  Please include anticipated attendance number.
Where is the calming area to be located? 
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How long are you requesting the sensory area for? 
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