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 23, 2017 from 9:30am-1:00pm
What is your full name? *
Your answer
What is your phone number? *
Your answer
What is your email address? *
Your answer
What is your preferred method of contact? *
Of your family members, what are the names of the ADULTS attending the Deaf+Autism Family Day event?
Your answer
Of your family members, what are the names (and ages) of the CHILDREN attending the Deaf+Autism Family Day event?
Your answer
What is your school district? *
Your answer
What do you/your family hope to get out of this event. *
Your answer
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. *
Your answer
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.) *
Your answer
If you are a volunteer, what things do you want to support?
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/programs/. Please save this information. Please write any additional information that you feel is important to share before this event.
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