Wings For Autism: October 3, 2026 Worcester Regional Airport

INSTRUCTIONS

Please read carefully before completing form!

1. Please provide the total number of people from your family attending the event. Be sure to include yourself in the total!

2. Proceed to registration. Please register the primary contact for your group FIRST, as Attendee #1. This should be the person who you want us to contact with event details and reach out to if we have any questions.

How many attendees are you registering?

Name

First NameLast Name

Email

example@example.com

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

Date of Birth

MonthDayYear

Gender

Does this attendee have a disability?

Diagnosis of child/adult with disability

Other

T-shirt size of child/adult with disability

Relationship to child/adult with disability

Other

Name

First NameLast Name

Is address the same as Attendee #1/Primary Contact?

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Date of Birth

MonthDayYear

Gender

Does this attendee have a disability?

Diagnosis of child/adult with disability

Other

T-shirt size of child/adult with disability

Relationship to child/adult with disability

Other

Name

First NameLast Name

Is address the same as Attendee #1/Primary Contact?

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Date of Birth

MonthDayYear

Gender

Does this attendee have a disability?

Diagnosis of child/adult with disability

Other

T-shirt size of child/adult with disability

Relationship to child/adult with disability

Other

Name

First NameLast Name

Is address the same as Attendee #1/Primary Contact?

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Date of Birth

MonthDayYear

Gender

Does this attendee have a disability?

Diagnosis of child/adult with disability

Other

T-shirt size of child/adult with disability

Relationship to child/adult with disability

Other

Name

First NameLast Name

Is address the same as Attendee #1/Primary Contact?

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Date of Birth

MonthDayYear

Gender

Does this attendee have a disability?

Diagnosis of child/adult with disability

Other

T-shirt size of child/adult with disability

Relationship to child/adult with disability

Other

Name

First NameLast Name

Is address the same as Attendee #1/Primary Contact?

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Date of Birth

MonthDayYear

Gender

Does this attendee have a disability?

Diagnosis of child/adult with disability

Other

T-shirt size of child/adult with disability

Relationship to child/adult with disability

Other

PERMISSION TO ALLOW PHOTO/VIDEO/AUDIO PUBLISHED

Although access to Wings for Autism is restricted to registered participants, it occurs in a public venue with hundreds of families and volunteers taking photos and videos of their loved ones participating in the event. While every attempt will be made to ensure a family’s privacy, it cannot be guaranteed. Please take this into consideration when deciding whether to participate in the event.

Please complete

Event Registration: Wings For Autism

INSTRUCTIONS

REGISTRATION

Attendee #1/Primary Contact

Attendee #2

Attendee #3

Attendee #4

Attendee #5

Attendee #6