Recreational Classes Registration
Important:
After you submit a form for registration, we will send you an email confirming attendance. Acceptance into classes is based on open availability in the class. Confirmation emails will take about 24-48 hours after registration submission.
Guardian Information
Guardian Full Name (If same as participant's name please list participant's name)
*
First Name
Last Name
E-mail
*
Contact Number
*
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Area Code
Phone Number
Student Information
Full Name
*
First Name
Last Name
Age
*
Birthdate
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Month
-
Day
Year
Date
Support From Adults
Please Select
Low Support
Medium Support
High Support
Support from adults needed to be successful in class setting.
Will payment for classes be private pay or OPWDD Self Direction Budget?
Self Direction Agency
If applicable.
Please tell us more about the participant (likes/dislikes) so that we can form a positive relationship with them
Emergency Contact
Health Concerns
Please click the classes you'd like to register your child for:
Making Connections (Social Skills): Ages 6-10 // Thursdays, 5:30-6:30 p.m.
Music Exploration: Ages 6-11 // Mondays, 4:15-5:15 p.m.
Music Exploration: Ages 12+ // Mondays, 5:30-6:30 p.m.
Cooking: Ages 16+ // Mondays, 5:30-6:30 p.m.
Best Me! Confidence Building: Ages 11-15 // Thursdays 4:15-5:15 p.m.
Best Me! Confidence Building: Ages 16+ // Wednesdays 5:30pm-6:30pm
Art Exploration: Ages 6-11 // Tuesdays 4:15-5:15pm
Art Exploration: Ages 12+ // Tuesdays 5:30-6:30pm
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