Bubbles and Beach Balls Summer Bash Registration

Bubbles and Beach Balls Summer Bash Registration

This event is designed specifically for the families we serve through UnPuzzled Parents Connect, creating a safe, welcoming, and inclusive environment for children with autism and intellectual and developmental disabilities and the people who love and support them.
If you haven't done so already, please go to our website and complete the Support Form before filling out this registration.

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Parent's Full Name

First NameLast Name
Email
example@example.com
Number of adults attending
Number of children attending
Ages of children
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
County you live in (Wood, Washington, etc.)
Would your family be willing to help contribute an item? We are looking for things like ice, chips, desserts, and other simple snack items to help make the day fun for everyone?
Give a donation
Waiver of Responsibility: By submitting this form, I acknowledge that I am the parent or legal guardian of the child(ren) listed above and accept full responsibility for their safety and behavior during the Bubble Bash Summer Pop Up event.
Photography/Media Waiver: I understand and agree that photos and videos of my child(ren) may be taken during the event and used by the organizers for social media, website, and promotional materials.
I acknowledge and agree to the Waiver of Responsibility
I acknowledge and agree to the Photography/Media Waiver
Parent/Guardian Signature (required to accept waivers and terms)
Should be Empty: