Grandparents Brunch - October 2023
Grandparent's First & Last Name
*
Street Address
*
Town/City
*
State
*
Zip Code
*
I give Community Autism Resources permission to have myself, my family members, or any person(s) that I have registered for this Event to be photographed/videotaped for educational/publicity purposes only:
*
Yes
No
I understand that participation in this event is at our own risk and will not hold Community Autism Resources liable for personal injury or loss/damage of personal property:
*
Yes
Email
*
Telephone Number
*
Grandchild/children with ASD First & Last Name
*
Grandchild/children's Age
*
Name of Town/City your Grandchild/ children lives in
*
# of people attending:
*
Please submit no more than 2 questions for our speaker:
Submit
Should be Empty: