Registration

Phone

This field is for validation purposes and should be left unchanged.

Name*

First Last

Family Name*

Email*

Phone*

Username*

Password*

Enter Password Confirm Password

Strength indicator

Address*

Street Address City State ZIP Code

Information for Individual You Support

Does the individual you are registering have Down syndrome?*

Yes
No

This helps us keep our programs sized, staffed and insured for the families we serve.

A note about membership
We apologize, but as a fully volunteer private organization that does not receive state, federal or national organization funding and are chartered to serve individuals with Down syndrome, we are at full capacity for individuals without DS. You may be able to submit a new user registration if our numbers change and there is extra room at activities. If you are looking for a specific program, we may be able to direct you to resources in the region.

You are welcome to complete this registration so we have your information, and you can email [email protected] any time with questions.

Name of Individual*

Birthdate*

Allergies

Sensory Issues

Interests

Other Notes

Buddy Walk Family Fun Day

Something on nearly every week of the year

New User Registration

Information for Individual You Support

Buddy Walk Family Fun Day

Something on nearly every week of the year

Registration

New User Registration

Information for Individual You Support

Welcome back,