Get Air Trampoline Park - Swansea - May 3, 2025
Parent's First & Last Name
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Child/Children with ASD's First & Last Name
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Date of Birth
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Month
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Day
Year
Date
DDS Eligibility
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DDS
Autism Division
I have not applied yet
Applied still waiting to hear back
Street Address
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Town/City
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Zip Code
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Telephone Number
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Can this number receive text?
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Yes
No
Email Address- All correspondence from us will be made to this email address.
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TOTAL # of people attending - immediate family (ie, parents/ guardians & siblings) only - please call with questions)
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TOTAL # of people JUMPING
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I give Community Autism Resources & The Doug Flutie Jr. Foundation 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.
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Yes
No
I understand that participation in this event is at our own risk and will not hold Community Autism Resources or The Doug Flutie Jr. Foundation liable for personal injury or loss/damage of personal property:
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Yes
I hereby agree to notify CAR if I am unable to attend this event (either by email or phone listed on confirmation). Notification should be received prior to the event or up to 24 hours after the event whenever possible. If such notification is not received by CAR, I understand that I will be unable to attend CAR events for 6 months from the date of this event.
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Yes
Are there any accommodations that you will need that we should be aware of (sensory, behavior, etc)?
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