Crafty Club Registration
Thursdays, 2-3:30pm | The Ability Collective of Barry County
Participant Name
*
First Name
Last Name
Preferred Name / Nickname
I am completing this form as
*
Please Select
Participant
Parent
Guardian
Support Worker
Person Completing Form (if different)
Participant Date of Birth
*
-
Month
-
Day
Year
Date Picker Icon
Primary Contact Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Primary Contact Email
*
example@example.com
Emergency Contact Information
Primary Emergency Contact Name
*
First Name
Last Name
Primary Emergency Contact Relationship
*
Please Select
Parent/Guardian
Spouse/Partner
Sibling
Grandparent
Relative
Friend
Neighbor
Other
Primary Emergency Contact Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Secondary Emergency Contact Name
First Name
Last Name
Secondary Emergency Contact Relationship
Please Select
Parent/Guardian
Spouse/Partner
Sibling
Grandparent
Relative
Friend
Neighbor
Other
Secondary Emergency Contact Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Accommodations and Support Needs
Communication style
*
Verbal
Non-Speaking / Uses AAC device
Gestures / Signs
Needs extra processing time
Other
Level of support needed during activities
*
Independent
Needs occasional reminders/prompts
Needs 1-on-1 hands-on guidance
Will bring an individual support person/aide
Other accommodations or support needs
Shirt Size
Unisex T-Shirt Size
*
Photo/Video Release
At The Ability Collective, we love capturing the joy, energy, and breakthroughs at our programs and events! We use these photos and videos on our website, social media, and marketing materials to share our mission and celebrate our community. You are in control. You can revoke this consent at any time. If you change your mind, email us at hello@theabilitycollective.org, and we will promptly remove you/your child's images from our digital platforms and future materials.
Do you grant The Ability Collective to take photos and/or videos? These may be used for promotional, educational, or marketing purposes.
*
YES, I grant full permission.
YES, but do not use names.
YES, but do not use on social media (will be used for internal purposes only such as print marketing or newsletters).
NO, I do not grant permission. Please do not take or use photos/videos.
Other
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