Club Membership Registration Form

Autism Dads Social Club Membership Form

Complete the form below to sign up to join our club.
Name

First NameLast Name
E-mail
Phone Number

Area CodePhone Number
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Birth Date

MonthDayYear
Relationship Status

SingleMarrriedOther
How many children do you have?
Please tell us about your child on the spectrum (Name, Age, School, ABA Service)
Why are you interested in becoming a member of the Autism Dads Social Club?
What type of support or resources are you seeking as a father of a child with autism?
Have you participated in any other autism or special needs groups? If yes, please provide details.
What skills, experiences, or knowledge do you bring to the club that could benefit members and the autism community?
Please specify any scheduling constraints or preferences as it relates to attending club meetings, events, and activities.
Where did you hear about us?

A Friend or colleaugeGoogleWebsiteNews ArticleOther
Preferred way to contact

PhoneEmailAny
Autism Dads Social Club T-Shirt Size

MLXLXXLXXXL
Membership Rules
1. Membership is available to anyone 18 years of age or older who parents a child diagnosed with autism.

2. Official members must make an annual $30 donation to the Autism Dads Social Club. Donations support scheduled autism community family events and dads socials.

3. Members must be willing to volunteer at Autism Dads Social Club community events.

4. Membership in the Autism Dads Social Club is subject to approval. Members should abide by the club rules, bylaws, and code of conduct.
My Products
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Annual Charter Membership Subscription
$40.00 Quantity

Annual Circle Membership Subscription
$360.00 Quantity
Please visit www.autismdadssocialclub.org to learn more about our group. We are a brotherhood of dads committed to understanding, accepting, and celebrating our autistic loved ones. Our mission is to develop social bonds with dads, to affirm, aid, and advocate for autistic youth, and to deepen autism family and community connections.

I have understood the rules and responsibilities of membership in the Autism Dads Social Club.

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Autism Dads Social Club Membership Form

Membership Rules