The Lasso 2019
A monthly activities group to meet our community and have some fun!
GENERAL INFORMATION
Please complete all of the following in detail.
Participant Name *
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Participant Age
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Participant Phone
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Participant Email
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Participant Gender
Parent/Caregiver Name
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Relationship to Participant
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Parent/Caregiver Phone
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Parent/Caregiver Email
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Parent/Caregiver Address
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Participant's Primary Diagnosis
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Main Effects of Primary Diagnosis
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Participant's Secondary Diagnosis
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Main Effects of Secondary Diagnosis
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Seizures?
Frequency, Type of Seizures, Duration, and method of management?
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Date of Last Seizure?
MM
/
DD
/
YYYY
Can Participant Tell if a Seizure is Going to Occur?
Medications (Please list all current meds, dosages, frequency, and side effects)
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Can the Participant Self-Administer Medication, if Needed, During the Activity?
Food Allergies (Please list all)
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Restricted Activities for the Participant
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Behaviors (Please list types, frequency, triggers, and effective management techniques)
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THE EVENTS
Sign up for all interested in. Participants can pay in cash on the day of the event. All transportation to and from the event locations provided by Participants' family or caregivers. Please contact Jonah with any questions: jonah@talltalesranch.org
February 9th-Game Night at Enchanted Grounds 8800 S Colorado Blvd, Highlands Ranch, CO 80126: 2:00-5:00 pm (Event is free. Suggested $10 per participant for food and drink purchase)
March 10th-Escape Room-The Clue Room 7286 S Yosemite St Unit 180, Centennial, CO 80112: 1:00-3:00 pm ($20)
April 14th-Line Dancing at The Grizzly Rose 5450 N Valley Hwy, Denver, CO 80216: 6:30-9:00 pm (Event is free. Suggested $15 per participant for food and drinks)
May 11th-Rock Climbing at Earth Treks 1050 W Hampden Ave, Englewood, CO 80110: 1:00-3:30 pm ($60)
June 9th-Rockies Game at Coors Field 2001 Blake St, Denver, CO 80205: 10:30-2:30 pm ($25)
July 13th-Tennis at Greenwood Athletic Club 5801 S Quebec St, Greenwood Village, CO 80111 1:00-4:00 pm ($10)
August 18th-Carnival for Kids Service Project Volunteers of America 4855 W Colfax Ave. Denver, CO 80204 1:00-3:00 pm ($10)
September 15th- Group Hike at the Mack in CO. Springs (Meet at the TTR Office): 12:00-3:00 pm ($10 for lunch)
October 13th- Dessert at the Inventing Room 4433 W 29th Ave #101, Denver, CO 80212 1:00-3:00 pm ($15)
November 10th-Karaoke at the Voicebox 2601 Walnut St. Denver, CO 80205 2:00-4:00 pm ($15)
December-Avalanche Game at the Pepsi Center 1000 Chopper Cir. Denver, CO 80204: (Date/Time TBA) ($20)
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