NEXT Chapter Book Club

Are you interested in being a part of a Next Chapter Book Club?

What is the Next Chapter Book Club? It's a unique community-based book club program for adolescents and adults with Down syndrome, autism, cerebral palsy and other intellectual and developmental disabilities. Our members (including some who cannot read) love books for the same reasons most people do. They enjoy being transported to different worlds where they meet interesting characters and learn about exciting new things. Taking that journey with a group of friends makes it even more delightful and fun.

Doesn't that sound like fun? We think so. In order to start a club, we will need lots of participants and volunteers. Please complete our Next Chapter Book Club sign up forms and let us know what part of town you are in so we can connect you to a club as close to your neighborhood as possible!

Book Club Member Registration and Intake Form

* Indicates required field

Name *

First

Last

Nickname *

Address *

Line 1

Line 2

City

State

Zip Code

Country

Date of Birth *

Email *

Phone Number *

T-shirt size *

How do you generally travel to places? (i.e. bus, walk, uber, someone drives me, etc.) *

How far can you travel? (Check all that apply) *

I can ONLY meet within walking distance or very close to home I can ONLY go a short distance by bus or car. I can meet anywhere: transportation in not an issue for me I can meet virtually

What days of the week and times work best for you to participate in a 1 hour book club?. *

What kind of books do you like to read? *

Are there things you should not eat or drink? (if yes please list) *

Do you have any health issues we should know about? (if so please list) *

Transportation Contact *

First

Last

Phone Number *

Relationship *

Email *

Emergency Contact *

First

Last

Phone Number *

Relationship *

Email *

Guardian *

First

Last

Phone Number *

Email *

*IMPORTANT* If you have a medical condition or any self-harm, verbal or physical aggression that may require immediate attention, your staff, parent, guardian or the person who brought you must remain on the premises during the meeting. Emergency Contact will be called for any emergency
Please read or listen carefully to the following statements:
* I understand that more than 3 absences within a 3 month period may result in my dismissal from the club in order to allow someone else to attend in my place.
* I understand that Next Chapter Book Club (NCBC) Staff may photograph book and or videotape me and I agree they may use these photos and or videos for the purpose of telling others about NCBC.
* I understand that I have to follow the guidelines of the NCBC, DSAA NE and the Host facility of the book club.
* I understand that NCBC cannot provide transportation to or from the book club meeting. I will make arrangement to arrive at book club meetings on time and I will be picked up on time.
* I understand that NCBC volunteers cannot provide one-to-one behavior or medical support and I will bring someone to help me if I have support need. I understand that NCBC can ask me to leave the club if my behavior is disruptive, aggressive, or otherwise inappropriate.

I have read or listened to the NCBC guidelines and will follow them to the best of my ability. *

I agree

By entering the name of the Book Club member, I agree to follow the above guidelines *

By entering the name of the Parent or Guardian you signify that you agree on behalf of the Book Club Memeber (if appropriate) *

Date *

Submit

Are you interested in being a part of a Next Chapter Book Club?

Book Club Member Registration and Intake Form

We Would Love to Hear from you!

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