Application

An online sports broadcasting experience for individuals age 10-17 with autism or developmental disabilities.
Participant Name Participant Address Age Participant Home Phone Participant Cell Phone Participant E-mail School Participant Attends Grade Diagnosis Favorite Sports Teams Interests and Preferred Activities Parent/Guardian Name Parent/Guardian Address Parent/Guardian Home Phone Parent/Guardian Cell Phone Parent/Guardian E-mail Is there anything you would like your child’s instructor to know about your child, please include here: Emergency Contact Name and Phone Number How did you hear about us? If you were referred by someone, let us know who Submit