Welcome!
= Required Information
Thank you for showing interest in our Class.
Session: Music Therapy for Adults, 18 Years and Older 6/22/22
Session Date:
June 22, 2022
Session Time: 6:00pm - 7:00pm PST
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
*
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
January
February
March
April
May
June
July
August
September
October
November
December
2022
2023
2024
2025
2026
2027
2028
Sun
Mon
Tue
Wed
Thu
Fri
Sat
Today
