Welcome!
= Required Information
Thank you for showing interest in our Class.
Session: This Music Therapy Tweens & Teens 6/11/22 has been cancelled
Session Date:
June 11, 2022
Session Time: 2:30pm - 3:30pm, 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
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