Adult Art Summer Lemon Paint Event 6-6-26
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 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
Liability Release & Assumption of Risk-By registering for this event, I acknowledge that participation for myself and my family members (including minors) is voluntary and may involve certain risks of personal injury, illness, or loss/damage of personal property. I agree to assume all such risks and, on behalf of myself and my family, release and hold harmless Community Autism Resources, its staff, volunteers, and event partners from any and all claims or liabilities that may arise from our participation, including those resulting from ordinary negligence (but not gross negligence or willful misconduct).I also give permission for emergency medical treatment to be provided if necessary and agree to be financially responsible for any related costs. I have read and understand this release, and agree that it will apply to me, my family members, and anyone I register for this event.
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Yes
If I can’t attend, I will contact Community Autism Resources by email or phone (listed on my confirmation) before the event or within 24 hours after. If I don’t let CAR know, I may not be able to register for events for up to 6 months. We understand that emergencies happen, and exceptions may be made.
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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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