CADC Group Registration
Thank you for showing interest in one of our group/club activities. Please fill out this form below and hit submit to register. Thank you.
Participant Name *
Your answer
Participant Birthdate *
MM
/
DD
/
YYYY
Participant's age *
Phone Number *
Your answer
Parent/Guardian's Name *
Your answer
Parent/Guardian's Email Address *
Your answer
Participant's School (if applicable)
Your answer
Participant's Grade (if applicable)
Your answer
Does the participant have a medical diagnosis? (This information will help us provide the most appropriate resources and tools for your child) *
If yes, what diagnosis do they have?
Your answer
Does the participant require any special accommodations? *
If yes, please explain.
Your answer
Does the participant engage in any aggressive behaviors? (when anxious, transitioning, upset, etc.) *
If yes, please explain. ( This information will help us create a personalized system for your child to help them better cope)
Your answer
Does participant have any allergies? (light snacks will be provided and cooking activities will occur) *
If yes, please explain.
Your answer
Submit
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