INCLUDE Registration
INCLUDE is a dance workshop designed specifically for children with special needs such as autism spectrum disorder and related disabilities.
Email address
Child's First and Last Name
Child's Age
Help us get to know your child! What are some of his/her favorite things? Are there any tactile, visual, auditory stimulus that are triggers? Is your child able to participate in a class without one-on-one assistance (this is not a requirement of class participation)?
Briefly explain any dance, theatre, or music experience that your child has had in the past. (Previous experience is not required!)
Parent/Guardian #1 (First and Last Name)
Parent/Guardian #1 Cell Phone
Parent/Guardian #2 (First and Last Name)
Parent/Guardian #2 Cell Phone
Will your child be able to attend each lesson of the workshop? (Attendance each week is important for the group as well as your child's experience)
How did you hear about INCLUDE?
There will be a photo and video documentation of this workshop. Do you give permission for your child's image to be used in print, web and otherwise? MCB makes no compensation for use of images.
A copy of your responses will be emailed to the address you provided.
Please complete the captcha before submitting the form.
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