DSCBA Class Session Registration
Welcome!
= Required Information
Thank you for showing interest in our Class.
Session: Music Therapy for Babies & Crawling Children, 5/20/23
Session Date:
May 20, 2023
Session Time: 10:00 - 11:00am, PST
Para la versión en español de esta página haga clic aquí:
Link:
https://dscba.secure.force.com/dscba/ClassSessionRegistrationES?sid=a0v5w00000OwIl1AAF
Class Session Registration
= Required Information
Responder
First Name
Last Name
Phone Number
Cell Phone
Email Address
Individual with Down Syndrome
First Name
Last Name
Date of Birth
[
3/29/2023
]
So we can best serve you, what disability does your child have (Down syndrome, Cerebral Palsy, Autism etc.)
Acknowledgement
How many sibling will participate?
*
Acknowledgement of Parent/Guardian attendance & participation during class.
I authorize DSCBA use of photos, film or video of me or my child(ren) during class for use on DSCBA social media pages, website, publications, grant proposals and reports.
YES
NO
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