DSCBA Class Session Registration

Class Session Registration

= Required Information

First Name
Last Name
Date of Birth	[ 5/29/2023 ]
So we can best serve you, what disability does your child have (Down syndrome, Cerebral Palsy, Autism etc.)

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.

Session: Dad's Night Out (Virtual), 6/25/23
Session Date: June 25, 2023
Session Time: 7:30pm - 9:00pm, PST