Living in the Gift Mindset Parent Zoom May 19, 2025
Parent's First & Last Name
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Child's First & Last Name
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Child's 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 for either
Applied waiting to hear back
Street Address
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Town/City
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State
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Zip Code
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Email (confirmations will be sent to this address)
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Telephone Number
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Can this phone number receive text messages:
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Yes
No
I give Community Autism Resources, and their sponsors, 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 liable for personal injury or loss/damage of personal property:
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Yes
Comments
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Should be Empty: