BeeSafe Elopment Project Registration Form

BeeSafe Elopment Project Registration Form
Attendee Information

Please fill name and contact information of attendees.
Your Name

PrefixFirst NameLast Name
Email Address
example@example.com
Contact Number
Please enter a valid phone number.
Is your child currently in any form of ABA therapy?

YesNoIn the past, but not currently
Age of Child:
ASD Severity Level:
You understand that by attending this meeting that the BeeSafe Elopement Project is NOT individualized and does NOT prevent elopement. Elopement is best prevented by actively engaging in ongoing safety measures. BeeSafe is BCBA led and will go over limited monthly topics related to ABA and safety. BeeSafe does not guarantee that children will not elope.
I have read the above statement and understand that to prevent elopement ongoing safety measures must be proactively implemented.*

I understand and I agree.
You will receive alerts about this event the closer to the date and a meeting link. This meeting will be recorded for the safety of participants. This is a kind and respectful space. We do not judge others and ask that if you join this meeting that you respect other families, including any sound related to stimming or ASD or questions within the Q&A. Families DO NOT have to make themselves visible throughout the meeting and can maintain home privacy.
Would you like to be updated about the upcoming events?

YesNo
Should be Empty:

Attendee Information