Community Video Game Day

Nintendo Switch Video Game Night

At BAC Natick
Community Game Day is back this fall with new and improved gaming! Join us for a night of games on the Nintendo Switch! Games and controllers will be provided, and participants are welcome to bring their own games and personal devices as well. We can't wait to see you there!

FRIDAYS

5:45-7:15pm

September 13th

October 11th

November 15th

December 13th

BAC Natick

This event is intended for neurodivergent tweens and teens ages 9-17 to have a chance to meet new people and foster friendships. This is a non-therapeutic group, meaning BAC staff will be minimally involved in the facilitation of games and activities. To get started, please answer the questions below to make sure this group would be a good fit for your child!
Is your child comfortable participating in a group without caregiver or staff facilitation?

YesNo
Can your child communicate with similar-aged peers with minimal to no support?

YesNo
Can your child engage in games and activities with similar-aged peers with minimal to no support?”

YesNo
Thank you for your interest in game day. Given the high participant to staff ratio for this event, we unfortunately would not be able to provide the necessary level of support for your child. If you are interested in being added to an email list for future events, please email megan.romanczyk@bostonabilitycenter.com.

Community Video Game Night

Please fill out one registration/release form for EACH individual you wish to have participate in game night events.
Participant's name*

First NameLast Name
Participant's Date of Birth:*

MonthDayYear
Participant's age *
Participant's pronouns

Additional Information
Allergies (please include type of reaction)*
Medical Precautions and/or Adaptive Equipment Needs*
Is this participant currently receiving any therapeutic services (OT, PT, Speech, etc.). If so, please specify.*
How did you hear about this event?*

From my child's clinician at BACBAC social mediaFlyer in BAC's waiting roomBAC email communicationOther

In Case of Emergency...
Primary contact in case of emergency*

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Primary emergency contact phone number*

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Primary contact email address*
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Secondary contact in case of emergency*

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Secondary emergency contact phone number*

Area CodePhone Number
Our policy is to call 911 in the case of any medical emergency. Please indicate if you would like us to do otherwise, and what action you would like taken:
In the case of an emergency, it is likely that your child will be transported to Newton-Wellesley Hospital. If you prefer that your child be taken to a different hospital or facility, please indicate below.
I do hereby assume full responsibility for any and all damages, injuries, or losses that I may sustain or incur, if any, while attending or participating in any program, sport or physical activity through the Boston Ability Center. I hereby waive all claims against its instructors, or partners of the program, individually or otherwise, for any and all claims for injuries or damages that I might sustain.

I understand that there is risk of injury associated with participating in any facility exercise, program, or sports activity. I certify that I am in good physical condition and have no known disabilities that might otherwise be detrimental to my health or well-being. I certify that all of the information provided on this application is correct and true to the best of my knowledge.

All applicants must sign. Parents or guardians must sign if participant is UNDER 18.
Signature of Parent/Legal Guardian:*

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Name of Parent/Legal Guardian:*

First NameLast Name
Date:*

MonthDayYear

Photo and Video Consent Form

(optional)
I hereby grant The Boston Ability Center permission to use my child’s likeness in a photograph or video in any and all of its publications, including website entries, without payment or any other consideration. I understand and agree that these materials will become the property of The Boston Ability Center and will not be returned. I hereby irrevocably authorize The Boston Ability Center to edit, alter, copy, exhibit, publish or distribute photos or videos for purposes of publicizing The Boston Ability Center’s programs or for any other lawful purposes. In addition, I waive the right to inspect or approve the finished product, including written or electronic copy, wherein the likeness of my child appears. Additionally, I waive any right to royalties or other compensation arising or related to the use of photographs or videos. I hereby hold harmless and release and forever discharge The Boston Ability Center from all claims, demands, and causes of action which I, my heirs, representatives, administrators, or any other persons acting on my child’s behalf may take.
Parent/Guardian Signature

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Parent/Guardian Printed Name
Date

MonthDayYear
Date

Payment
Please select which event(s) you would like your child to attend:
prevnext( X )
Friday November 15th$25.00

Friday December 13th$25.00

Total $0.00

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Nintendo Switch Video Game Night

Community Video Game Night

Additional Information

In Case of Emergency...

Photo and Video Consent Form

Payment