ASP AUdventure Registration

ASP Membership Category*

Regular MemberAssociate MemberNot yet a member

What event are you signing up for?*

Complete Name*

First NameLast Name

Email*

example@example.com

Mobile Number*

09XX123-4567

ASP Chapter*

ASP Membership Number

Membership Renewal Date

Check your membership card

Name of person on the autism spectrum*

First NameLast Name

Birthday

Name of companion*

First NameLast Name

Did you join the last Autism Angel Take Flight?

YesNo

Facebook URL*

Declaration of Informed Consent: I am making the following declarations, consistent with Autism Society Philippines' Protection Policy for individuals on the autism spectrum. I, as a representative of my family and other companions, am voluntarily participating in this ASP event:

	Agree	Disagree	Not Applicable
We will follow the instructions and guidance of ASP and partners, for our safety and well-being.
We are responsible for our own well-being and will not hold ASP and partners liable for untoward incidents.
We will respect our ASP, partners and fellow participants at all times.
We agree to have our photos and videos taken for documentation and to be published by the ASP and partners, for advocacy and education purposes (not commercial).
The content of this form has been clearly explained to me.

Declaration of Informed Consent: I am making the following declarations, consistent with Autism Society Philippines' Protection Policy for individuals on the autism spectrum. I, as a representative of my family and other companions, am voluntarily participating in this ASP event:

	Agree	Disagree	Not Applicable
We will follow the instructions and guidance of ASP and partners, for our safety and well-being.
We are responsible for our own well-being and will not hold ASP and partners liable for untoward incidents.
We have the right to ask questions and tell the facilitators if we want to continue or to rest.
We will respect our ASP, partners and fellow participants at all times.
We agree to have our photos and videos taken for documentation and to be published by the ASP and partners, for advocacy and education purposes (not commercial).
The content of this form has been clearly explained to me.

This event is for ASP members only, with priority given to regular ASP members. Please fill out our membership form and register again. Please be reminded that seats are limited and will be allocated on a first-come, first-served basis.