2025 Field Day Family Fun

FRIDAY, May 9, 2025

5:00-7:00pm

This event is open to all friends & families with autism. Teens are welcome to register and we will put them with adults if there are not enough teen participants. Parents are welcome to register to participate as well in events.

Activities Include:

Sack Races

Standing long jump

Hula Hoop

50 yd dash and Relays

3 Legged Race

Tug-o-war

Vendors

Games

Address: Irv Zeid Park, 9100 Old Olive Rd, Olivette, MO 63132

Parent / Guardian Info*

First NameLast Name

Parent / Guardian Info

First NameLast Name

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Email

example@example.com

Phone Number

Area CodePhone Number

Child Name*

First NameLast Name

Date of Birth*

Gender*

BoyGirl

Current Grade*

Include your child’s current grade.

Events: choose 3 Events for your child to participate in.

	40 yd dash	Sack race	3 Legged race	Standing long jump	Hula hoop	Obstacle Course
1st choice
2nd choice
3rd choice

Child Name

First NameLast Name

Date of Birth

Gender

BoyGirl

Current Grade

Include your child’s current grade.

Events: choose 3 Events for your child to participate in.

	40 yd dash	Sack race	3 Legged race	Standing long jump	Hula hoop	Obstacle Course
1st choice
2nd choice
3rd choice

Child Name

First NameLast Name

Date of Birth

Gender

BoyGirl

Current Grade

Include your child’s current grade.

Events: choose 3 Events for your child to participate in.

	40 yd dash	Sack race	3 Legged race	Standing long jump	Hula hoop	Obstacle Course
1st choice
2nd choice
3rd choice

Child Name

First NameLast Name

Date of Birth

Gender

BoyGirl

Current Grade

Include your child’s current grade.

Events: choose 3 Events for your child to participate in.

	40 yd dash	Sack race	3 Legged race	Standing long jump	Hula hoop	Obstacle Course
1st choice
2nd choice
3rd choice

Teen Name

First NameLast Name

Date of Birth

Current Grade

Include your child’s current grade.

Events: choose 3 Events for your child to participate in.

	40 yd dash	Sack race	3 Legged race	Standing long jump	Hula hoop	Obstacle Course
1st choice
2nd choice
3rd choice

Does your child have any of the safety concerns we need to be aware of (eloping, biting, etc)?

NOTICE

Please be advised that parents MUST supervise their children at all times.

Do you or your teen want participate in any events?

Any additional notes about accommodations or support that may be helpful to your family.

Informed Consent and Acknowledgement

I hereby give my approval for my child’s participation in any and all activities during the Freddie Ford Family Foundation Family Field Day. I assume all risk and hazards incidental to the conduct of the activities, and release, absolve and hold harmless the Foundation, partners, sponsors, vendors, volunteers, Board of Directors and all its respective officers, agents, and representatives from any and all liability for injuries to said child arising out of participating in this eventand associated activities.

In case of injury to said child, I hereby waive all claims against Freddie Ford Family Foundation, the venue, including all all participants, sponsoring agencies, advertisers, and, if applicable, owners and lessors of premises used to conduct the event. There is a risk of being injured that is inherent in all activities and races. Some of these injuries include, but are not limited to, the risk of sprains, strains, fractures, paralysis, or death.

Confirmation

BY ACKNOWLEDGING AND SIGNING BELOW, I AM DELIVERING AN ELECTRONIC SIGNATURE THAT WILL HAVE THE SAME EFFECT AS AN ORIGINAL MANUAL PAPER SIGNATURE. THE ELECTRONIC SIGNATURE WILL BE EQUALLY AS BINDING AS AN ORIGINAL MANUAL PAPER SIGNATURE.

Signature*

My Products

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Credit Card